Humoral SARS-CoV-2 vaccine responses are durable in solid organ transplant recipients with and without HIV.

BACKGROUND

Solid organ transplant (SOT) recipients may have a suboptimal humoral immune response to the coronavirus disease 2019 (COVID-19) vaccine, prompting the need for additional doses of vaccine for immunocompromised patients. However, data regarding immune responses to vaccination specifically in SOT recipients with well controlled HIV are lacking.

METHODS

We conducted a prospective observational cohort single-center study of SOT recipients with and without HIV-1 who had received two doses of mRNA COVID-19 vaccine and were planning to receive additional doses. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) binding and neutralizing antibody responses were measured at several time points after vaccination.

FINDINGS: Of the 122 SOT recipients enrolled, 44 (36%) were people with HIV (PWH). Overall, 65% (50/77) of all SOT recipients were seropositive prior to a third vaccine dose. Seropositive SOT recipients with HIV had comparable anti-spike antibody responses at baseline and over time to those without HIV. In addition, HIV status did not impact neutralizing titers in our SOT cohort. Twenty-seven participants were seronegative at baseline; three (11%) were participants with HIV. In addition, 78% (21/27) of participants seroconverted over the duration of the study; of those who remained seronegative, none had HIV, but all were on an antimetabolites.

INTERPRETATION: HIV status did not impact longitudinal spike-binding antibody titers or neutralizing titers in SOT recipients.