COVID-19 Vaccine Immune Response in Children with HIV

Children living with HIV had a similar immune response to mRNA COVID-19 vaccination as children without HIV.

The effect of COVID-19 vaccination in children who contracted HIV vertically (from their mothers) has not been thoroughly evaluated. One study, presented at this week’s 40th Annual Meeting of the European Society for Pediatric Infectious Diseases (ESPID), endeavored to do just that.

The investigators assessed the COVID-19 neutralizing antibody titers against the Delta and Omicron variants in children with vertically transmitted HIV infection. The children received the Pfizer-BioNTech (BNT162b2) COVID-19 vaccine and were monitored through the Pediatric Infectious Disease Unit at the Luigi Sacco Hospital in Milan, Italy.

The primary study cohort included 22 children with vertically transmitted HIV infection. The children were simultaneously undergoing antiretroviral therapy (ART).

Neutralizing antibody titers were assessed at 1 day before vaccination (T0), 25 days after the second vaccine dose (T1), and 6 months after the second dose (T2). After 6 months, antibody titers were compared to an age-matched cohort of 20 Pfizer-vaccinated, HIV-negative children.

Among the children living with HIV, the percentage of waning neutralizing antibody titers from T1 to T2 was 87.5% during Omicron and 82% during Delta. Notably, Delta displayed a moderate immune escape; Omicron titers were 456 during T1 while Delta titers were 144.

The pediatric HIV patients who had a previous COVID-19 infection had higher levels of neutralizing antibody titers during T1 and T2, and their titers dropped less than those with no COVID-19 infection history. There was no significant difference between the pediatric cohorts with and without vertically transmitted HIV.

The investigators concluded that Pfizer-BioNTech mRNA vaccination had a high immunogenicity profile for children living with HIV. They noted that neutralizing antibody titers are considered representative of COVID-19 protection, concluding by recommending a booster vaccine to maintain high levels of protection.

This study, “Humoral Immune Response in SARS-CoV-2 Vaccinated HIV-Vertically Transmitted Patients,” was presented during the 40th Annual Meeting of the European Society for Pediatric Infectious Diseases (ESPID), held online and in Athens, Greece from May 9-13, 2022.