‘HIV-positive people might need 3rd COVID-19 dose’



RESEARCHERS at the just-ended 18th European Aids Conference (EACS 2021) have reported that HIV-positive people with CD4 counts that are below 200 have weaker responses to some COVID-19 vaccines, and might need a third dose of the vaccine against the respiratory virus.

Presenting their evidence in London last week, the researchers said this group was significantly less likely to generate strong antibody and cellular immune responses compared to people with better immune function.

The findings match those of a United States study presented in early October, which showed that people with lower CD4 counts were less likely to produce antibody responses after two doses of an mRNA vaccine, especially the Pfizer vaccine.

Messenger RNA (mRNA) vaccines teach cells how to make a protein that will trigger an immune response inside bodies.

Following this new data, public health authorities in the US and Europe recommended a third dose of a vaccine against COVID-19 for people with HIV and immune suppression. However, there is still lack of clarity about which CD4 threshold a third dose is needed.

Andrea Antinori of the National Institute for Infectious Diseases and her colleagues designed the study to compare antibody and cellular immune responses after vaccination in people with HIV with severe immune deficiency (current CD4 count below 200) and those with moderate immune deficiency.

A second Italian research group looked at the incidence of side effects after receiving the Moderna vaccine in 453 people with HIV that were receiving care.

All participants were taking antiretroviral therapy, but people with CD4 counts below 200 were significantly more likely to have unsuppressed viral load compared to people with higher CD4 counts.

In Zimbabwe, while people with HIV can be vaccinated against COVID-19, those who are weak or sick cannot receive the jab until their condition has improved.

The conference also had survey findings from diverse settings, which revealed that there is generally little COVID-19 vaccine hesitancy among people living with HIV.

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