Abstract:
The kinetics of Fc-mediated functions following SARS-CoV-2 infection or
vaccination in people living with HIV (PLWH) are not known. We compared
SARS-CoV-2 spike-specific Fc functions, binding, and neutralization in PLWH
and people without HIV (PWOH) during acute infection (without prior
vaccination) with either the D614G or Beta variants of SARS-CoV-2, or
vaccination with ChAdOx1 nCoV-19. Antiretroviral treatment (ART)–naïve
PLWH had significantly lower levels of IgG binding, neutralization, and
antibody-dependent cellular phagocytosis (ADCP) compared with PLWH on
ART. The magnitude of antibody-dependent cellular cytotoxicity (ADCC),
complement deposition (ADCD), and cellular trogocytosis (ADCT) was
differentially triggered by D614G and Beta. The kinetics of spike IgG-binding
antibodies, ADCC, and ADCD were similar, irrespective of the infecting variant
between PWOH and PLWH overall. However, compared with PWOH, PLWH
infected with D614G had delayed neutralization and ADCP. Furthermore, Beta
infection resulted in delayed ADCT, regardless of HIV status. Despite these
delays, we observed improved coordination between binding and neutralizing
responses and Fc functions in PLWH. In contrast to D614G infection, binding
responses in PLWH following ChAdOx-1 nCoV-19 vaccination were delayed,
while neutralization and ADCP had similar timing of onset, but lower magnitude,