High seroconversion rate and SARS-CoV-2 Delta neutralization in people with HIV vaccinated with BNT162b2

Objectives: To assess humoral responses to SARS-CoV-2 Delta-variant in people with HIV (PWH) after BNT162b2-vaccination. Design: Multicenter cohort study of PWH with CD4(+) cell count less than 500 cells/mu l and viral load less than 50 copies/ml on stable antiretroviral therapy for at least 3 months. Methods: Anti-SARS-CoV-2 receptor-binding-domain IgG antibodies (anti-RBD IgG) were quantified and neutralization capacity was evaluated by ELISA/GenScript and virus-neutralization-test against the D614G-strain, beta and delta variants before vaccination (day 0) and 1 month after complete schedule (M1). Results: We enrolled 97 PWH, 85 received two vaccine shots. The seroconversion rate for anti-RBD IgG was 97% [95% confidence interval (CI) 90-100%] at M1. Median (IQR) anti-RBD IgG titer was 0.97 (0.97-5.3) BAU/ml at D0 and 1219 (602-1929) at M1. Neutralization capacity improved between D0 (15%; 50% CI 8-23%) and M1 (94%; 95% CI 87-98%) (P < 0.0001). At M1, NAbs against the D614G strain, beta and delta variants were present in 82, 77, and 84% PWH, respectively. The seroconversion rate and median anti-RBD-IgG level were 91% and 852 BAU/ml, respectively, in PWH with CD4(+) cell count less than 250 (n = 13) and 98% and 1270 BAU/ml for CD4(+)greater than 250 (n = 64) (P = 0.3994). NAbs were present in 73% of PWH with CD4(+) less than 250 and 97% of those with CD4(+) cell count greater than 250 (P = 0.0130). NAbs against beta variant were elicited in 50% in PWH with CD4(+) cell count less than 250 and in 81% of those with CD4(+) cell count greater than 250 (P = 0.0292). CD4(+) and CD8(+) T-cell counts were unchanged, whereas CD19(+) B-cell counts decreased after vaccination(208 +/- 124 at D0 vs. 188 +/- 112 at M1, P < 0.01). No notable adverse effects or COVID-19 cases were reported. Conclusion: Seroconversion rates were high, with delta-neutralization rates similar to those for the D61G strain, after a two-dose BNT162b2 vaccination in PWH.