Publication date: Jun 11, 2025

The aim of this study was to evaluate humoral and cellular immune responses in people living with HIV (PLWH) following successive COVID-19 vaccine booster doses, in order to determine immune correlates associated with clinical outcomes (avoiding severe infections) and epidemiological impacts (preventing new infections), a topic of growing controversy in this vulnerable population. A prospective study followed 151 PLWH on suppressive antiretroviral therapy who completed initial COVID-19 vaccination and received two additional vaccine doses. The study evaluated changes in SARS-CoV-2-specific antibodies, SARS-CoV-2-ACE2 binding inhibition rates, Spike-specific memory B cells, and CD4/CD8 cell responses to variants (Ancestral, Delta, and Omicron), considering initial vaccine type, prior infections, and levels of immunosuppression. Vaccine doses progressively enhanced antibody levels, memory B cells, and T-cell responses. PLWH with CD4 counts ≤350 cells/mm showed impaired memory B cell production versus those with CD4 >500 cells/mm after the third dose (0. 39% [0. 29-0. 55] vs 0. 68% [0. 49-0. 86]; p

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