After administering severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger RNA (mRNA) vaccinations to patients with human immunodeficiency virus (HIV; PWH) who had CD4+ T-cell counts <200/µL (HIV<200 group), researchers examined the humoral and cellular immune responses that were elicited.

In the prospective cohort analysis, 58 PWH in the HIV<200 group, 36 participants with CD4+ T-cell counts >500/µL (HIV>500 group), and 33 HIV-1-negative controls were included (control group). Antibodies against the receptor-binding domain (anti-RBD IgG) and the SARS-CoV-2 spike protein (anti-S immunoglobulin [Ig] G) were measured before and 4 weeks after the first and second doses of BNT162b2 or mRNA-1273 (at week 8). T-cell responses and viral neutralizing activity were also measured.

Anti-S/anti-RBD IgG responses increased in all groups at week 8 (P< .001). At week 8, the HIV<200 group’s median (interquartile range) anti-S and anti-RBD IgG levels were 153.6 (26.4-654.9) and 171.9 (61.8-425.8) binding antibody units (BAU)/mL, respectively, compared to 245.6 (145-824) and 555.8 (166.4-1751) BAU/mL in the HIV>500 groups and 274.7 (193.7-680.4) and 281.6 (181-831.8) BAU/mL in controls (P < .05) In comparison to 3.7% in the HIV>500 groups, neutralizing capability and specific T-cell immune responses were missing or diminished in 33% of individuals in the HIV<200 groups (P< .01).

After receiving coronavirus disease 2019 mRNA vaccinations, one-third of PWH with CD4+ T-cell counts <200/µL exhibited poor anti-S/anti-RBD IgG levels, impaired in vitro neutralization ability against SARS-CoV-2, and no vaccine-induced T cells.