# Effects of inactivated COVID-19 vaccination on HIV viremia and reservoir size: a longitudinal cohort study

## TL;DR

This study found that inactivated COVID-19 vaccines do not significantly increase HIV viral load but may reduce HIV DNA copies in people living with HIV.

## Contribution

This is the first longitudinal study to investigate the effects of inactivated COVID-19 vaccination on HIV viremia and reservoir size in people living with HIV.

## Key findings

- Inactivated COVID-19 vaccination did not significantly affect plasma viral load (pVL) in people living with HIV.
- HIV-1 total DNA copies showed a downward trend after vaccination, particularly in those with higher CD4+ T cell counts.
- Duration of HIV infection and RBD-specific IgG antibody levels were correlated with changes in HIV-1 DNA copies post-vaccination.

## Abstract

Vaccination is regarded as the most effective and cost-efficient mean of managing COVID-19. Whether receiving inactivated vaccine leads to plasma viral load (pVL) rebound and affects HIV reservoirs size has been a major concern for people living with HIV (PLWH). In this study we performed a longitudinal observational study to explore the dynamic changes of pVL and HIV-1 total DNA with PLWH after vaccination with inactivated COVID-19 vaccine.

Information and venous blood samples from PLWH were collected prevaccination (BC1), three weeks after the first vaccination (BC2), four weeks after the second dose (BC3), six months after the second dose (BC4), and two weeks after the third dose (BC5) to test RBD-specific IgG antibody, plasma viral load (pVL), HIV-1 total DNA and CD4+ T cell count.

A total of 25 PLWH participated in this study, with a median age of 34 (IQR 28.5 − 40.0) years. No significant difference in proportion of undetectable pVL group, pVL ≥ 20 cp/ml group and pVL < 20 cp/ml group was observed among five time points (p = 0.506). Significant difference was observed in total HIV-1 DNA copies among different time points in both group of CD4+ T cells ≤ 300 and > 300. In the group of nadir CD4+ T cells > 300, pairwise comparison of five sets of data showed that total HIV-1 DNA copies at BC5 was significantly lower than BC1 (P = 0.043) and BC3 (P = 0.008). And duration of HIV infection was positively correlated with HIV-1 DNA copies at BC4 (R = 0.729, p = 0.007) and BC5 (R = 0.690, p = 0.013), S/CO value of RBD-specific-IgG at BC3 were negatively correlated with HIV-1 total DNA copies at time points of BC2 (R=-0.713, p = 0.009) and BC3 (R=-0.587, p = 0.045).

Receiving inactivated COVID-19 vaccine didn’t significantly affect pVL. HIV-1 total DNA copies had a downward trend after vaccination. Duration of infection and IgG titer might be correlated with HIV-1 total DNA copies after vaccination.

The online version contains supplementary material available at 10.1186/s12879-025-12184-8.