tetano
Editor, Senior Moderator
Front Immunol
. 2025 Sep 17:16:1668576.
doi: 10.3389/fimmu.2025.1668576. eCollection 2025. Immunogenicity and safety of the booster COVID-19 vaccine among people with HIV: a systematic review and meta-analysis
Zhenzhen Chen[SUP] #[/SUP][SUP] 1 [/SUP], Chunping Wan[SUP] #[/SUP][SUP] 2 [/SUP], Bing Chen[SUP] #[/SUP][SUP] 3 [/SUP], Qingyan Mo[SUP] 2 [/SUP], Mingqian Ju[SUP] 2 [/SUP], Kunlong Deng[SUP] 1 [/SUP], Xiaohong Li[SUP] 2 [/SUP], Dongdong Qin[SUP] 4 [/SUP]
Affiliations
Background: Human immunodeficiency virus (HIV) and COVID-19 continue to pose significant global public health challenges. Although vaccination is essential for preventing COVID-19 in people with HIV (PWH), evidence on the immunogenicity and safety of booster doses remains limited. This systematic review aimed to assess the immunogenicity and safety of COVID-19 booster vaccination in PWH.
Methods: We conducted a comprehensive literature search in PubMed, EMBASE, and the Cochrane Library. Eligible studies included PWH who had received three or more doses of a COVID-19 vaccine.
Results: Across 54 included studies, 4,685 of 5,229 PWH achieved seroconversion following a third or subsequent COVID-19 vaccine dose-an improvement over rates observed after the primary vaccine series. In 23 studies comparing 2,284 PWH with 1,813 healthy controls (HC), no significant differences in seroconversion rates were found (p ≥ 0.05). Among PWH, 22 studies reported significantly higher seroconversion rates in individuals with CD4[SUP]+[/SUP] T cell counts >200 cells/mm³ compared to those with counts <200 cells/mm³. Booster vaccination enhanced CD4[SUP]+[/SUP] T cell responses to levels comparable to HC, although CD8[SUP]+[/SUP] T cell responses remained markedly lower. Five studies reported adverse events following booster doses, none of which were classified as serious.
Conclusion: COVID-19 booster vaccination is effective in enhancing immune protection and reducing severe disease in PWH. Optimal vaccine dosing is especially important in individuals with low CD4[SUP]+[/SUP] T cell counts. Tailoring booster strategies may improve seroconversion and overall immune response in this population.
Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024605151.
Keywords: CD4+ T cell; COVID-19; HIV; booster vaccines; immunogenicity; seroconversion.
. 2025 Sep 17:16:1668576.
doi: 10.3389/fimmu.2025.1668576. eCollection 2025. Immunogenicity and safety of the booster COVID-19 vaccine among people with HIV: a systematic review and meta-analysis
Zhenzhen Chen[SUP] #[/SUP][SUP] 1 [/SUP], Chunping Wan[SUP] #[/SUP][SUP] 2 [/SUP], Bing Chen[SUP] #[/SUP][SUP] 3 [/SUP], Qingyan Mo[SUP] 2 [/SUP], Mingqian Ju[SUP] 2 [/SUP], Kunlong Deng[SUP] 1 [/SUP], Xiaohong Li[SUP] 2 [/SUP], Dongdong Qin[SUP] 4 [/SUP]
Affiliations
- PMID: 41041302
- PMCID: PMC12484232
- DOI: 10.3389/fimmu.2025.1668576
Background: Human immunodeficiency virus (HIV) and COVID-19 continue to pose significant global public health challenges. Although vaccination is essential for preventing COVID-19 in people with HIV (PWH), evidence on the immunogenicity and safety of booster doses remains limited. This systematic review aimed to assess the immunogenicity and safety of COVID-19 booster vaccination in PWH.
Methods: We conducted a comprehensive literature search in PubMed, EMBASE, and the Cochrane Library. Eligible studies included PWH who had received three or more doses of a COVID-19 vaccine.
Results: Across 54 included studies, 4,685 of 5,229 PWH achieved seroconversion following a third or subsequent COVID-19 vaccine dose-an improvement over rates observed after the primary vaccine series. In 23 studies comparing 2,284 PWH with 1,813 healthy controls (HC), no significant differences in seroconversion rates were found (p ≥ 0.05). Among PWH, 22 studies reported significantly higher seroconversion rates in individuals with CD4[SUP]+[/SUP] T cell counts >200 cells/mm³ compared to those with counts <200 cells/mm³. Booster vaccination enhanced CD4[SUP]+[/SUP] T cell responses to levels comparable to HC, although CD8[SUP]+[/SUP] T cell responses remained markedly lower. Five studies reported adverse events following booster doses, none of which were classified as serious.
Conclusion: COVID-19 booster vaccination is effective in enhancing immune protection and reducing severe disease in PWH. Optimal vaccine dosing is especially important in individuals with low CD4[SUP]+[/SUP] T cell counts. Tailoring booster strategies may improve seroconversion and overall immune response in this population.
Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024605151.
Keywords: CD4+ T cell; COVID-19; HIV; booster vaccines; immunogenicity; seroconversion.