A team of scientists from the Johns Hopkins Bloomberg School of Public Health in Baltimore has conducted a study that revealed that people with HIV (PWH) have an increased risk for breakthrough COVID-19 infection after vaccination. The findings of the study were published online on June 7 in JAMA Network Open.
While conducting the study, Sally B. Coburn, Ph.D., M.P.H., and colleagues estimated the rate and risk of breakthrough infections among fully vaccinated PWH and persons without HIV (PWoH) in the United States. Moreover, data were included for 113,994 patients (33,029 PWH and 80,965 PWoH).
“The risk for breakthrough infection was higher in PWH than PWoH (adjusted hazard ratio, 1.28). An increased risk for breakthrough infection among PWH was seen in association with younger age (younger than 45 years versus 45 to 54 years), history of COVID-19, and not receiving an additional dose (adjusted hazard ratio, 0.71). Breakthrough infection was not associated with HIV viral load suppression, but among PWH, a high CD4 count was associated with fewer breakthroughs, the study revealed.
“Increased risk of breakthrough infections in PWH merits continued monitoring as the pandemic persists, immunity to primary vaccine series wanes, boosters are widely recommended, and new variants emerge,” the authors stated.
The scientists compared vaccine recipients with and without HIV and found that the chance of a positive SARS-CoV-2 test result or a COVID-19 diagnosis within nine months after full vaccination, though low, was 28 percent higher among people with HIV. Meanwhile, the risk of breakthrough infection during the period examined was 3.8 per cent for the non-HIV group and 4.4 percent for 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,” said Keri Althoff, senior author and associate professor in the Bloomberg School’s Department of Epidemiology.
Meanwhile, the health experts have had concerns about potentially elevated COVID-19 risk among people with weakened immune systems, including those with HIV, since the beginning of the pandemic.