Effect of hybrid immunity on the neutralizing antibody response to emerging SARS-CoV-2 variants including in people living with HIV.
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Date
2022
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Abstract
This work focused on the effect of SARS-CoV-2 variants and co-infection with HIV on the neutralizing
antibody response elicited by SARS-CoV-2 infection and vaccination. The first study described the
effect of HIV status and suppression on antibody neutralization capacity against the Delta variant
elicited by previous infection, the Janssen adeno vectored Ad26.CoV2.S vaccine, or hybrid immunity
from infection followed by Ad26.CoV2.S vaccination. It was determined that while neutralizing
immunity elicited by infection decreased in people living with HIV (PLWH) and particularly in those
with unsuppressed HIV viremia, this effect was counteracted with hybrid immunity from infection and
Ad26.CoV2.S vaccination, where with hybrid immunity neutralization levels increased and differences
between PLWH and HIV negative individuals became non-significant. With the emergence of the
Omicron variant, we investigated whether Omicron infection boosts cross-neutralizing antibody levels
against other variants. It was determined that this cross-protection does occur but is considerably
stronger in people with hybrid immunity consisting of Pfizer BNT162b2 mRNA or the Ad26.CoV2.S
vaccination followed by breakthrough infection, implying that hybrid immunity from Omicron variant
infection and vaccination may prevent infection with other, more pathogenic variants. Lastly, we
demonstrated the escape of the BA.4 and BA.5 subvariants from Omicron BA.1 subvariant elicited
immunity. It was found that BA.4 and BA.5 showed substantial escape from BA.1 elicited immunity in
the absence of vaccination, but the escape was more moderate in individuals with hybrid immunity from
BA.1 infection combined with vaccination. Overall, these studies show the capacity of hybrid
immunity, consisting of vaccination and infection, to reduce the negative effects of HIV viremia and
emerging variants on the ability of the pre-existing immunity to neutralize SARS-CoV-2.
Description
Doctoral Degree. University of KwaZulu-Natal, Durban.