Journal Article

Correlates of Breakthrough SARS-CoV-2 Infections in People with HIV: Results from the CIHR CTN 328 Study

Margolese, Shari, Walmsley, Sharon, Mandarino, Enrico, Kovacs, Colin, Hull, Mark, Harris, Marianne, Cooper, Curtis L., Lee, Terry, Samarani, Suzanne, Singer, Joel, Burchell, Ann N., Brockman, Mark A., Galipeau, Yannick, Langlois, Marc-André, Costiniuk, Cecilia T., Needham, Judy, Chambers, Catharine, Samji, Hasina, Tan, Darrell H. S., Brumme, Zabrina L., Ostrowski, Mario, Lebouché, Bertrand, Angel, Jonathan B., Jenabian, Mohammad-Ali, Routy, Jean-Pierre, Lapointe, Hope R., Anis, Aslam H., Arnold, Corey

2024

Overview

COVID-19 breakthrough infection (BTI) can occur despite vaccination. Using a multi-centre, prospective, observational Canadian cohort of people with HIV (PWH) receiving ≥2 COVID-19 vaccines, we compared the SARS-CoV-2 spike (S) and receptor-binding domain (RBD)-specific IgG levels 3 and 6 months post second dose, as well as 1 month post third dose, in PWH with and without BTI. BTI was defined as positivity based on self-report measures (data up to last study visit) or IgG data (up to 1 month post dose 3). The self-report measures were based on their symptoms and either a positive PCR or rapid antigen test. The analysis was restricted to persons without previous COVID-19 infection. Persons without BTI remained COVID-19-naïve until ≥3 months following the third dose. Of 289 participants, 92 developed BTI (31.5 infections per 100 person-years). The median days between last vaccination and BTI was 128 (IQR 67, 176), with the most cases occurring between the third and fourth dose (n = 59), corresponding to the Omicron wave. In analyses adjusted for age, sex, race, multimorbidity, hypertension, chronic kidney disease, diabetes and obesity, a lower IgG S/RBD (log10 BAU/mL) at 1 month post dose 3 was significantly associated with BTI, suggesting that a lower IgG level at this time point may predict BTI in this cohort of PWH.

• Publisher: MDPI AG
• Subject: Analysis / Antigens / breakthrough infection / Care and treatment / Chronic kidney failure / Comorbidity / COVID-19 / COVID-19 vaccination / COVID-19 vaccines / Development and progression / Diabetes mellitus / Health aspects / HIV / HIV (Viruses) / HIV patients / Human immunodeficiency virus / humoral immunity / Hypertension / immunogenicity / Immunoglobulin G / Infection / Infections / Informed consent / Kidney diseases / Lymphocytes / Patient outcomes / Proteins / Public health / SARS-CoV-2 / Severe acute respiratory syndrome coronavirus 2 / Sexually transmitted diseases / Signs and symptoms / Sociodemographics / Statistical analysis / STD / Vaccines / Viral diseases