People living with HIV (PLWH) exhibit heterogeneous immune responses, influenced by varying degrees of immune deficiency and viral suppression. The efficacy of COVID-19 vaccines in this population remains underexplored, particularly in those with low CD4 counts. This study assessed the antibody response in PLWH with CD4 T-cell levels ≤200 cells/mm3 compared to those with higher levels, following a bivalent mRNA COVID-19 vaccine booster. All participants were on effective Antiretroviral therapy (ART) with virologic suppression and had received the booster more than a year after their last vaccination. Participants with lower CD4 counts exhibited reduced baseline Anti-RBD IgG titers. However, significant increases in Anti-RBD IgG and surrogate virus neutralization test (sVNT) levels were observed across both CD4 groups post-booster. Despite lower Geometric mean titer (GMT) in the low CD4 group, this group achieved a higher post-boost Anti-RBD IgG Geometric mean ratio (GMR), indicating a robust vaccine response facilitated by effective ART. Nonetheless, cross-neutralization against the circulating XBB variant was limited. Although individuals in the low CD4 group exhibited reduced protection at baseline, they showed significant increase in Anti-RBD IgG and sVNT levels across all CD4 counts after receiving the bivalent COVID vaccine booster.
Copyright: © 2025 Hiranburana et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.