PDF(Pubmed)
Abstract：
COVID-19 breakthrough infection (BTI) can occur despite vaccination. Using a multi-centre, prospective, observational Canadian cohort of people with HIV (PWH) receiving ≥2 COVID-19 vaccines, we compared the SARS-CoV-2 spike (S) and receptor-binding domain (RBD)-specific IgG levels 3 and 6 months post second dose, as well as 1 month post third dose, in PWH with and without BTI. BTI was defined as positivity based on self-report measures (data up to last study visit) or IgG data (up to 1 month post dose 3). The self-report measures were based on their symptoms and either a positive PCR or rapid antigen test. The analysis was restricted to persons without previous COVID-19 infection. Persons without BTI remained COVID-19-naïve until ≥3 months following the third dose. Of 289 participants, 92 developed BTI (31.5 infections per 100 person-years). The median days between last vaccination and BTI was 128 (IQR 67, 176), with the most cases occurring between the third and fourth dose (n = 59), corresponding to the Omicron wave. In analyses adjusted for age, sex, race, multimorbidity, hypertension, chronic kidney disease, diabetes and obesity, a lower IgG S/RBD (log10 BAU/mL) at 1 month post dose 3 was significantly associated with BTI, suggesting that a lower IgG level at this time point may predict BTI in this cohort of PWH.
摘要：
尽管接种了疫苗，但仍可能发生COVID-19突破性感染（BTI）。使用多中心，prospective,观察加拿大接受≥2种COVID-19疫苗的HIV感染者（PWH）队列，我们比较了SARS-CoV-2峰值（S）和受体结合域（RBD）特异性IgG水平3和6个月后，以及第三次给药后1个月，在有和没有BTI的PWH中。BTI被定义为基于自我报告测量(数据直到最后一次研究访问)或IgG数据(直到剂量3后1个月)的阳性。自我报告措施是基于他们的症状和阳性PCR或快速抗原测试。该分析仅限于以前没有感染过COVID-19的人。没有BTI的人在第三次给药后≥3个月时仍未接受COVID-19治疗。在289名参与者中，92例发生BTI（每100人年31.5例感染）。最后一次疫苗接种和BTI之间的中位天数为128天（IQR67,176），大多数病例发生在第三和第四剂量之间（n=59），对应于Omicron波。在按年龄调整的分析中，性别,种族,多浊度,高血压,慢性肾病,糖尿病和肥胖症,剂量3后1个月IgGS/RBD（log10BAU/mL）降低与BTI显着相关，提示在该时间点较低的IgG水平可能预测该PWH队列中的BTI。
