Pleuropulmonary and Bronchial Infections

COVID-19 Booster May Spur Seroconversion in Blood Cancer Patients

Individuals on PrEP who become infected with HIV, such as those with poor adherence to treatment, may have delayed seroconversion on blood-based and oral-fluid-based rapid antibody tests.2 In one study, oral antibody reactivity was first observed a median of 125 days (range, 14-547 days) after HIV RNA or antibodies were observed in the blood.13 In another study, individuals who received PrEP were 3.49 times more likely than those on placebo to experience a delay of >100 days in detecting the infection.14 Based on these and other findings in the literature, it has been suggested that laboratory-based serum or plasma HIV tests should be used whenever possible to monitor individuals on PrEP.2 Additionally, in the setting of known or suspected poor PrEP adherence, the threshold for augmenting p24/IgM/IgG assays with NAT should be lowered.2

Individuals on PrEP who become infected with HIV, such as those with poor adherence to treatment, may have delayed seroconversion on blood-based and oral-fluid-based rapid antibody tests.2 In one study, oral antibody reactivity was first observed a median of 125 days (range, 14-547 days) after HIV RNA or antibodies were observed in the blood.13


In another study, individuals who received PrEP were 3.49 times more likely than those on placebo to experience a delay of >100 days in detecting the infection.14 Based on these and other findings in the literature, it has been suggested that laboratory-based serum or plasma HIV tests should be used whenever possible to monitor individuals on PrEP.2 Additionally, in the setting of known or suspected poor PrEP adherence, the threshold for augmenting p24/IgM/IgG assays with NAT should be lowered.2

For patients with hematologic malignancy without seroconversion after initial COVID-19 vaccination, seroconversion often occurs after booster vaccination.

HealthDay News — For patients with hematologic malignancy without seroconversion after initial COVID-19 vaccination, seroconversion often occurs after booster vaccination, according to a study published online July 11 in Cancer.

Thomas A. Ollila, M.D., from the Alpert Medical School of Brown University in Providence, Rhode Island, and colleagues analyzed serological responses to initial and booster COVID-19 vaccination in 378 patients with hematologic malignancy and examined subsequent COVID-19-related outcomes.

The researchers found that 48 percent of the patients had seroconversion after initial vaccination; the lowest rates of seroconversion were seen for patients with active malignancy or those who were recently treated with a B-cell-depleting monoclonal antibody. Seroconversion occurred after a booster dose in 56 percent of the 85 initial nonresponders to vaccination. After the booster, the seroconversion rate was similar for patients on and off active therapy (53 and 58 percent, respectively). Overall, 8.8 percent of the patients developed COVID-19 infection; three COVID-19-related deaths occurred (0.8 percent). There was no significant association between postvaccination seroconversion and the incidence of COVID-19 infection; however, none of the patients with seroconversion died from COVID-19. None of the 25 patients who received tixagevimab/cilgavimab was diagnosed with COVID-19 infection.

“When we looked at outcomes, we found that deaths from COVID-19 in the patient population we reviewed only occurred in those with undetectable antibodies, and nobody who received prophylactic antibody therapy was diagnosed with COVID-19,” Ollila said in a statement. “This suggests to us the importance of checking antibody levels in these patients and arranging prophylactic antibody therapy.”

Several authors disclosed financial ties to the biopharmaceutical industry.

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