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Open Access 21-01-2023 | Vaccination

Immunologic Interplay Between HIV/AIDS and COVID-19: Adding Fuel to the Flames?

Authors: Matteo Augello, Valeria Bono, Roberta Rovito, Camilla Tincati, Giulia Marchetti

Published in: Current HIV/AIDS Reports | Issue 2/2023

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Abstract

Purpose of Review

HIV/AIDS and COVID-19 have been the major pandemics overwhelming our times. Given the enduring immune disfunction featuring people living with HIV (PLWH) despite combination antiretroviral therapy (cART), concerns for higher incidence and severity of SARS-CoV-2 infection as well as for suboptimal responses to the newly developed vaccines in this population arose early during the pandemics. Herein, we discuss the complex interplay between HIV and SARS-CoV-2, with a special focus on the immune responses to SARS-CoV-2 natural infection and vaccination in PLWH.

Recent Findings

Overall, current literature shows that COVID-19 severity and outcomes may be worse and immune responses to infection or vaccination lower in PLWH with poor CD4 + T-cell counts and/or uncontrolled HIV viremia. Data regarding the risk of post-acute sequelae of SARS-CoV-2 infection (PASC) among PLWH are extremely scarce, yet they seem to suggest a higher incidence of such condition.

Summary

Scarce immunovirological control appears to be the major driver of weak immune responses to SARS-CoV-2 infection/vaccination and worse COVID-19 outcomes in PLWH. Therefore, such individuals should be prioritized for vaccination and should receive additional vaccine doses. Furthermore, given the potentially higher risk of developing long-term sequelae, PLWH who experienced COVID-19 should be ensured a more careful and prolonged follow-up.
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go back to reference • Feng Y, Zhang Y, He Z, Huang H, Tian X, Wang G, et al. Immunogenicity of an inactivated SARS-CoV-2 vaccine in people living with HIV-1: a non-randomized cohort study. EClinicalMedicine. 2022;43:101226. https://doi.org/10.1016/j.eclinm.2021.101226. (This study showed that BBIBP-CorV is able to induce similar anti-RBD Ig, neutralization activity, and T-cell responses between HIV-negative individuals and PLWH overall; however, humoral responses are weaker in PLWH with low CD4/CD8 ratio compared to PLWH with medium or high ratio.)CrossRefPubMed • Feng Y, Zhang Y, He Z, Huang H, Tian X, Wang G, et al. Immunogenicity of an inactivated SARS-CoV-2 vaccine in people living with HIV-1: a non-randomized cohort study. EClinicalMedicine. 2022;43:101226. https://​doi.​org/​10.​1016/​j.​eclinm.​2021.​101226. (This study showed that BBIBP-CorV is able to induce similar anti-RBD Ig, neutralization activity, and T-cell responses between HIV-negative individuals and PLWH overall; however, humoral responses are weaker in PLWH with low CD4/CD8 ratio compared to PLWH with medium or high ratio.)CrossRefPubMed
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go back to reference Schmidt KG, Harrer EG, Tascilar K, Kübel S, El Kenz B, Hartmann F, et al. Characterization of serum and mucosal SARS-CoV-2-antibodies in HIV-1-infected subjects after BNT162b2 mRNA vaccination or SARS-CoV-2 infection. Viruses. 2022;14(3). https://doi.org/10.3390/v14030651. Schmidt KG, Harrer EG, Tascilar K, Kübel S, El Kenz B, Hartmann F, et al. Characterization of serum and mucosal SARS-CoV-2-antibodies in HIV-1-infected subjects after BNT162b2 mRNA vaccination or SARS-CoV-2 infection. Viruses. 2022;14(3). https://​doi.​org/​10.​3390/​v14030651.
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Metadata
Title
Immunologic Interplay Between HIV/AIDS and COVID-19: Adding Fuel to the Flames?
Authors
Matteo Augello
Valeria Bono
Roberta Rovito
Camilla Tincati
Giulia Marchetti
Publication date
21-01-2023
Publisher
Springer US
Published in
Current HIV/AIDS Reports / Issue 2/2023
Print ISSN: 1548-3568
Electronic ISSN: 1548-3576
DOI
https://doi.org/10.1007/s11904-023-00647-z

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