Durability of ChAdOx1 nCov-19 (AZD1222) vaccination in people living with HIV - responses to SARS-CoV-2, variants of concern and circulating coronaviruses

  1. Ane Ogbe
  2. Mathew Pace
  3. Mustapha Bittaye
  4. Timothy Tipoe
  5. Sandra Adele
  6. Jasmini Alagaratnam
  7. Parvinder K Aley
  8. M. Azim Ansari
  9. Anna Bara
  10. Samantha Broadhead
  11. Anthony Brown
  12. Helen Brown
  13. Federica Cappuccini
  14. Paola Cinardo
  15. Wanwisa Dejnirattisai
  16. Katie J. Ewer
  17. Henry Fok
  18. Pedro M. Folegatti
  19. Jamie Fowler
  20. Leila Godfrey
  21. Anna L. Goodman
  22. Bethany Jackson
  23. Daniel Jenkin
  24. Mathew Jones
  25. Stephanie Longet
  26. Rebecca Makinson
  27. Natalie G. Marchevsky
  28. Moncy Mathew
  29. Andrea Mazzella
  30. Yama F. Mujadidi
  31. Lucia Parolini
  32. Claire Petersen
  33. Emma Plested
  34. Katrina M. Pollock
  35. Thurkka Rajeswaran
  36. Maheshi N. Ramasamy
  37. Sarah Rhead
  38. Hannah Robinson
  39. Nicola Robinson
  40. Helen Sanders
  41. Sonia Serrano
  42. Helen Stockmann
  43. Tom Tipton
  44. Anele Waters
  45. Panagiota Zacharopoulou
  46. Eleanor Barnes
  47. Susanna Dunachie
  48. Philip Goulder
  49. Paul Klenerman
  50. Gavin R. Screaton
  51. Alan Winston
  52. Adrian V. S. Hill
  53. Sarah C. Gilbert
  54. Miles Carroll
  55. Andrew J Pollard
  56. Sarah Fidler
  57. Julie Fox
  58. Teresa Lambe
  59. John Frater
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Abstract

Duration of protection from SARS-CoV-2 infection in people with HIV (PWH) following vaccination is unclear. In a sub-study of the phase 2/3 the COV002 trial (<ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="clintrialgov" xlink:href="NCT04400838">NCT04400838</ext-link>), 54 HIV positive male participants on antiretroviral therapy (undetectable viral loads, CD4+ T cells >350 cells/ul) received two doses of ChAdOx1 nCoV-19 (AZD1222) 4-6 weeks apart and were followed for 6 months. Responses to vaccination were determined by serology (IgG ELISA and MesoScale Discovery (MSD)), neutralisation, ACE-2 inhibition, gamma interferon ELISpot, activation-induced marker (AIM) assay and T cell proliferation. We show that 6 months after vaccination the majority of measurable immune responses were greater than pre-vaccination baseline, but with evidence of a decline in both humoral and cell mediated immunity. There was, however, no significant difference compared to a cohort of HIV-uninfected individuals vaccinated with the same regimen. Responses to the variants of concern were detectable, although were lower than wild type. Pre-existing cross-reactive T cell responses to SARS-CoV-2 spike were associated with greater post-vaccine immunity and correlated with prior exposure to beta coronaviruses. These data support the on-going policy to vaccinate PWH against SARS-CoV-2, and underpin the need for long-term monitoring of responses after vaccination.

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