RISK OF BREAKTHROUGH COVID-19 infection after vaccination is higher in people with HIV when compared to people without HIV. The study, carried out at the Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA, analysed health records following public health concerns about potentially elevated COVID-19 risk among people with weakened immune systems, including those with HIV, at the beginning of the pandemic.
The research team analysed the anonymised health records of 113,995 people considered to be fully vaccinated, with either two doses of the mRNA vaccine or a single dose of the viral vector vaccine. Data was pooled on an individual level from four health systems in the USA, with all patients having received previous care for different conditions. Of the study group, 33,029 patients who were HIV-positive were compared to 80,965 patients who were HIV-negative.
They found that the chance of a positive COIVD-19 test result or diagnosis within 9 months of full vaccination was 28% higher in individuals with HIV than those without. The overall risk of breakthrough infection was 3.8% for the non-HIV group and 4.4% in the HIV group.
“These findings should alert all people with HIV to their greater risk of COVID-19 breakthrough and can inform official recommendations about COVID-19 vaccination for people with HIV,” stated senior study author Keri Althoff, Johns Hopkins University.
Furthermore, the study found an increased risk of breakthrough infection with increasing immune suppression, demonstrated through decreased CD4+ T cell counts. The study authors summarised that this suggested HIV-positive individuals with moderate immune suppression may need to be included in at risk groups entitled to additional doses of vaccine.
“Policymakers who establish the guidelines should consider the benefits and risks of an additional dose of vaccine in the primary series, not only for those with severe or untreated HIV, but also include those with moderate immune suppression or even all persons with HIV,” stated primary study author Sally Coburn, Johns Hopkins University.