Serological Response Following COVID-19 Vaccines in Patients Living with HIV: A Dose-Response Meta-Analysis

Objective: To quantify the pooled rate and risk ratio of seroconversion following the uncomplete, complete, or booster dose of COVID-19 vaccines in patients living with HIV.Method: Pubmed, Embase and Cochrane library were searched for eligible studies published from inception to 13th, September 2022. The pooled rate and risk ratio of seroconversion were assessed using the Freeman-Tukey double arcsine method and Mantel-Haenszel approach, respectively. Random-effects model was preferentially used as the primary approach to pool results across studies. This systematic review and meta-analysis protocol was registered with PROSPERO (CRD42022359603).Results: In this meta-analysis, we comprehensively analyzed 50 studies with a total of 7160 patients living with HIV. We demonstrated that only 75.0% (56.4% to 89.9%) patients living with HIV achieved a seroconversion after uncomplete vaccination, which improved to 89.3% (84.2% to 93.5%) after complete vaccination, and 98.4% (94.8% to 100%) after booster vaccination. The seroconversion rates were significantly lower compared to controls at all the stages, while the risk ratios for uncomplete, complete, and booster vaccination were 0.87 (0.77 to 0.99), 0.95 (0.92 to 0.98), and 0.97 (0.94 to 0.99), respectively. Notably, meta-regression and subgroup analyses suggested that year of publication, study location and vaccine type could cause the difference of the pooled rate or risk ratio of seroconversion for patients living with HIV after complete vaccination. Sensitivity analysis did not much change the results.Conclusions: We concluded that vaccine doses were associated with consistently improved the rate and risk ratio of seroconversion in patients living with HIV, highlighting the significance of booster vaccination for patients living with HIV.Trial Registration Details: This systematic review and meta-analysis protocol was registered with PROSPERO (CRD42022359603). Funding Information: This research is supported by the National Natural Science Foundation of China (no. 82102803, 82103183, 82272849), and Natural Science Foundation of Hunan province (no. 2021JJ40976, 2022JJ40767).Declaration of Interests: No conflict of interest declared.