HIV medicine · 2026
HIV-1 viral load and reservoir size remain stable following SARS-CoV-2 mRNA vaccination in people with HIV.
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Kieri Oscar, Jütte Bianca B, Vesterbacka Jan, Aleman Soo, Ljunggren Hans-Gustaf, Buggert Marcus, Svensson J Peter, Sönnerborg Anders, Nowak Piotr
Аннотация
BACKGROUND: The potent immunogenicity of mRNA vaccination raised concerns about its impact on HIV-1 viral load (VL) and reservoir size in people with HIV, which could drive vaccine hesitancy. As part of a prospective clinical trial, we investigated whether SARS-CoV-2 mRNA vaccination induced changes in VL and reservoir size after a 1-year three-dose regimen in people with HIV on antiretroviral therapy (ART).
METHODS: We collected blood samples from 37 people with HIV with varying degrees of immune reconstitution before vaccination and after receiving their second and third doses of vaccine. Anti-SARS-CoV-2-Spike antibodies and Spike-specific CD4+T-cells were analysed as indicators of vaccine-induced immunogenicity. The Intact Proviral DNA Assay was used to quantify the intact and defective HIV-1 reservoir.
RESULTS: Vaccination with three doses of SARS-CoV-2 mRNA vaccine over the course of 1 year did not result in plasma HIV-1 RNA rebound nor significantly alter the HIV-1 reservoir size regardless of immune status. The median intact HIV-1 reservoir size was 53 (IQR 34-193) copies/million CD4+T-cells at baseline and 86 (34-268) and 138 (33-334) 3 months after the second and third dose, respectively (p > 0.38). We found no correlation between changes in VL or HIV-1 reservoir size and the anti-SARS-CoV-2-Spike levels, Spike-specific CD4+T-cells, CD4+/CD8+ ratio, nadir or CD4+T-cell count. However, the intact reservoir size negatively correlated with CD4+T-cell count, CD4+/CD8+ ratio and nadir CD4+T-cell count.
CONCLUSIONS: Our findings show that three doses of SARS-CoV-2 mRNA vaccine did not affect the VL or HIV reservoir size regardless of immune status, supporting their safety in people with HIV. Notably, a higher CD4+T-cell count correlated with a reduced intact HIV-1 reservoir size.
METHODS: We collected blood samples from 37 people with HIV with varying degrees of immune reconstitution before vaccination and after receiving their second and third doses of vaccine. Anti-SARS-CoV-2-Spike antibodies and Spike-specific CD4+T-cells were analysed as indicators of vaccine-induced immunogenicity. The Intact Proviral DNA Assay was used to quantify the intact and defective HIV-1 reservoir.
RESULTS: Vaccination with three doses of SARS-CoV-2 mRNA vaccine over the course of 1 year did not result in plasma HIV-1 RNA rebound nor significantly alter the HIV-1 reservoir size regardless of immune status. The median intact HIV-1 reservoir size was 53 (IQR 34-193) copies/million CD4+T-cells at baseline and 86 (34-268) and 138 (33-334) 3 months after the second and third dose, respectively (p > 0.38). We found no correlation between changes in VL or HIV-1 reservoir size and the anti-SARS-CoV-2-Spike levels, Spike-specific CD4+T-cells, CD4+/CD8+ ratio, nadir or CD4+T-cell count. However, the intact reservoir size negatively correlated with CD4+T-cell count, CD4+/CD8+ ratio and nadir CD4+T-cell count.
CONCLUSIONS: Our findings show that three doses of SARS-CoV-2 mRNA vaccine did not affect the VL or HIV reservoir size regardless of immune status, supporting their safety in people with HIV. Notably, a higher CD4+T-cell count correlated with a reduced intact HIV-1 reservoir size.