HealthDay News — People with HIV (PWH) have an increased risk for breakthrough severe acute respiratory syndrome coronavirus 2 infection after vaccination, according to a study published online June 7 in JAMA Network Open.

Sally B. Coburn, Ph.D., M.P.H., from the Johns Hopkins Bloomberg School of Public Health in Baltimore, and colleagues estimated the rate and risk of breakthrough infections among fully vaccinated PWH and persons without HIV (PWoH) in the United States. Data were included for 113,994 patients (33,029 PWH and 80,965 PWoH).

The researchers found that PWH had a higher rate of breakthrough infections than PWoH (55 versus 43 cases per 1,000 person-years). At nine months after full vaccination, the cumulative incidence of breakthroughs was low (3.8 percent), but was higher in PWH than PWoH (4.4 versus 3.5 percent) and within each vaccine type. The risk for breakthrough infection was higher in PWH than PWoH (adjusted hazard ratio, 1.28). An increased risk for breakthrough infection among PWH was seen in association with younger age (younger than 45 years versus 45 to 54 years), history of COVID-19, and not receiving an additional dose (adjusted hazard ratio, 0.71). Breakthrough infection was not associated with HIV viral load suppression, but among PWH, a high CD4 count was associated with fewer breakthroughs.


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“Increased risk of breakthrough infections in PWH merits continued monitoring as the pandemic persists, immunity to primary vaccine series wanes, boosters are widely recommended, and new variants emerge,” the authors write.

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