SARS-CoV-2 antibody prevalence in adults living with HIV.

Abstract

Objectives: To measure SARS-CoV-2 antibody seroprevalence within a cohort of adults living with HIV and correlate demographics with response rates to SARS CoV-2 vaccination.

Design: Initial vaccine trials for SARS CoV-2 did not examine efficacy in people with HIV. We undertook the SCAPE-HIV study from April 2021 to November 2022 to focus on vaccine response in this population to guide future vaccine scheduling.

Methods: Participants completed a retrospective questionnaire. Nucleocapsid and spike antibodies to SARS CoV-2 (anti-N and anti-S) were tested. Demographic and HIV factors (CD4, viral load) were correlated with quantitative serological outcomes. Anti-S titres less than 400U/mL were considered low level. Follow-up was performed in a subset post third vaccination.

Results: Six hundred and twelve participants completed the study questionnaire, 520 were included in the final analysis. Most participants received either ChAdOx1-S recombinant vaccine or the BNT162b2 mRNA vaccine for the first 2 doses. Almost all participants (99.2%) in the main group had an anti-S antibody detected above the assay cutoff (>0.8U/mL). Most participants (77.3%) had anti-S titres greater than 400U/mL, with the median titre 1734U/mL. Age over 60 years was significantly associated with lower (<400U/mL) anti-S antibody titre (p < 0.0001).

Conclusions: We demonstrate a high rate of anti-S seropositivity following SARS-CoV-2 vaccination in people with HIV. Age over 60 was the only parameter found to be associated with a lower anti-S antibody titre. Our findings suggest that COVID-19 vaccine scheduling should target older persons living with HIV in line with the general population.