Immunogenicity and efficacy of COVID-19 vaccines in people living with HIV: a systematic review and meta-analysis

Abstract

ObjectiveAvailable data show that COVID-19 vaccines may be less effective in people living with HIV (PLWH), who are at increased risk of severe COVID-19. This meta-analysis aimed to compare immunogenicity and efficacy of COVID-19 vaccines in PLWH with healthy individuals.MethodsPubmed/Medline, EMBASE, and the Cochrane Library were searched. Risk ratios of seroconversion were separately pooled with the use of random effects meta-analysis, and systematic review without meta-analysis of SARS-CoV-2 antibody titer levels was performed after the first and second doses of a COVID-19 vaccine.ResultsTwenty-two studies with 6522 subjects met the inclusion criteria. After first vaccine dose, seroconversion in PLWH was comparable to that in healthy individuals. After a second dose, seroconversion was slightly lower in PLWH compared with healthy controls, and antibody titers did not seem to be significantly affected or reduced among participants of both groups.ConclusionsCOVID-19 vaccines show favorable immunogenicity and efficacy in PLWH. A second dose is associated with consistently improved seroconversion, although it is slightly lower in PLWH compared with healthy individuals. Additional strategies, such as a booster vaccination with mRNA COVID-19 vaccines, might improve seroprotection for these patients.