The clinical outcomes of coronavirus diseases 2019 (COVID-19) in people with human immunodeficiency virus (PWH) are variable. Early data involving small sample sizes showed no increased risk [1], but a recent meta-analysis demonstrated an increased risk of COVID-19 mortality in PWH [2]. Nonetheless, administration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines elicits strong immunogenicity in PWH with minimal adverse effects [3]. Despite both human immunodeficiency virus (HIV) and SARS-CoV-2 being positive-sense, single-stranded ribonucleic acid (RNA) viruses, one major difference between these 2 viruses is that most individuals infected with SARS-CoV-2 are able to clear the virus, whereas HIV persists in PWH despite years of antiretroviral therapy (ART) that allows near complete virologic suppression and control. In this regard, the persistent HIV reservoir in the CD4+ T-cell compartment of the vast majority of PWH receiving ART is one of the major impediments to the eradication of the virus [4]. Previous studies have shown that vaccination against common pathogens, such as influenza, may modulate immunologic and virologic parameters in PWH receiving ART [5]. Given that one of the proposed mechanisms of HIV persistence is antigen-mediated clonal expansion and homeostatic proliferation of an existing pool of CD4+ T cells carrying intact HIV provirus, it is of interest to investigate whether the SARV-CoV-2 booster vaccination modulates immunologic and virologic parameters in PWH receiving ART.
In the present study, we set out to investigate the effects of the SARV-CoV-2 booster vaccine on HIV reservoir size, immune markers, and host immune responses to HIV and SARS-CoV-2 in a cohort of HIV-positive individuals receiving ART after the SARS-CoV-2 booster vaccination.