Uplifting results from the UK, South Africa and Israel. Both AstraZeneca and the Pfizer / Biontech vaccine generate antibodies to Covid-19 in people living with HIV.
The UK study
54 people with HIV between the ages of 18-55 with undetectable virus levels and at least 350 CD4 cells received two doses of the AstraZenenca vaccine. Doses were given at four to six week intervals.
The group was followed for 56 days and test results were compared with a group of 50 people who did not live with HIV. No differences were seen between the groups in how well antibodies developed or how well they worked in neutralizing Covid-19.
The researchers found that AstraZeneca’s vaccine generally worked just as well in the group of people living with HIV as without, but that more data are needed for people with HIV who have CD4 below 350 or measurable virus levels.
The South Africa study
A group of people with HIV received either two doses of AstraZenenca’s vaccine or a placebo. The people with HIV in the study had CD4 levels between 512 – 929, were on average 40 years old and all study participants were on treatment for HIV. A majority had been under treatment for HIV for more than five years. 99 people with HIV completed the 42-day study and were compared with a group that did not live with HIV, a group that was slightly younger on average (32 years).
The study measured how well people with HIV developed antibodies. The results after 42 days, when the second dose was given, showed no differences between people with or without HIV, in the ability to develop antibodies to Covid-19. However, the researchers, like their colleagues in the UK, requested more data for people with lower CD4 levels.
The Israel study
143 people with HIV between the ages of 24 and 84 were included in the study. On average, the group had lived with HIV for 13 years, but the range was large, from living with HIV for less than a year to 36 years. Almost 20% had at some point been diagnosed with AIDS. Notably, 15 people had CD4 levels below 350, a group that was not represented in the studies in the UK and South Africa. All study participants were on treatment for HIV.
The 143 people received two doses of Pfizer / Biontech vaccine a few weeks apart and were compared with a group of people without HIV. Two weeks after the first dose, a majority of both groups developed antibodies to Covid-19. However, people with HIV developed fewer antibodies. After the second dose, 98% and 99% of the groups had developed antibodies, respectively, and on average a fivefold increase in antibodies was detected.
The subgroup of people with HIV with CD4 levels below 350 had developed high levels of antibodies after the second dose. Hence, there is an indication that even immunosuppressed individuals, with lower CD4, benefit from vaccination.
The researchers also noted a small decrease in CD4 levels in general in the group of people living with HIV, which is in line with what has been observed in other studies. That is, white blood cells decrease somewhat in connection with a vaccination. However, no changes were seen in the immune system and its function as the relationship between CD4 and CD8 did not change. In other words, it may be normal to see a small dip of CD4 after vaccination.
None of the studies have been peer-reviewed, but the observations still give uplifting and positive signals that the various available vaccinations work well on people living with HIV. We are waiting for more studies and there will probably be more during the summer and autumn.