Vaccination with COVID-19 mRNA-1273 is not associated with HIV-RNA blips among people with HIV on ART: a retrospective cohort study

Objectives: Viral blips (VB) have been reported in people with HIV (PWH) after COVID-19 vaccination. Materials and Methods: We performed a retrospective cohort study among virally suppressed PWH vaccinated against COVID-19 with mRNA-1273, comparing the occurrence of VB in the 12 months after the first vaccine shot with those recorded in the 12 months before. The association between several clinical and immunologic variables and VB have been evaluated through logistic regression. Results: Overall, 48 individuals were included in our analysis. No difference was recorded between VB incidence in the 12 months before and after vaccination [11/48 (23%) vs 15/48 (31.3%), p=0.42]. No significant association was detected between selected variables and VB occurrence after vaccination. In a post hoc analysis including also 8 PWH excluded for not reaching the definition of viral suppression, we observed 15 increases of HIV RNA out of 56 PWH (26.8%) before vaccination and 23 increases of HIV RNA out of 56 PWH after vaccination (41.1%). This difference in incidence remained not significant (p=0.10) but a strong association between increases of HIV RNA occurrence before and after vaccination [p=0.02, OR 4.3 (95% CI 1-22-15.17)] was found. Conclusion: Among virally suppressed PWH, COVID-19 vaccination with mRNA-1273 is not associated with increased occurrence of VB.