Breakthrough COVID-19 Infections after Booster SARS-CoV-2 Vaccination in a Greek Cohort of People Living with HIV during the Delta and Omicron Waves
Konstantinos Protopapas,
Konstantinos Thomas,
Charalampos D. Moschopoulos,
Eirini Oktapoda,
Eirini Marousi,
Eirini Marselou,
Nikiforos Stamoulis,
Christos Filis,
Pinelopi Kazakou,
Chrysanthi Oikonomopoulou,
Georgios Zampetas,
Ourania Efstratiadou,
Katerina Chavatza,
Dimitra Kavatha,
Anastasia Antoniadou,
Antonios Papadopoulos
Affiliations
Konstantinos Protopapas
4th Department of Internal Medicine, University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens, 1 Rimini Str., Chaidari, 12462 Athens, Greece
Konstantinos Thomas
4th Department of Internal Medicine, University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens, 1 Rimini Str., Chaidari, 12462 Athens, Greece
Charalampos D. Moschopoulos
4th Department of Internal Medicine, University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens, 1 Rimini Str., Chaidari, 12462 Athens, Greece
Eirini Oktapoda
4th Department of Internal Medicine, University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens, 1 Rimini Str., Chaidari, 12462 Athens, Greece
Eirini Marousi
4th Department of Internal Medicine, University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens, 1 Rimini Str., Chaidari, 12462 Athens, Greece
Eirini Marselou
4th Department of Internal Medicine, University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens, 1 Rimini Str., Chaidari, 12462 Athens, Greece
Nikiforos Stamoulis
4th Department of Internal Medicine, University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens, 1 Rimini Str., Chaidari, 12462 Athens, Greece
Christos Filis
4th Department of Internal Medicine, University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens, 1 Rimini Str., Chaidari, 12462 Athens, Greece
Pinelopi Kazakou
4th Department of Internal Medicine, University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens, 1 Rimini Str., Chaidari, 12462 Athens, Greece
Chrysanthi Oikonomopoulou
4th Department of Internal Medicine, University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens, 1 Rimini Str., Chaidari, 12462 Athens, Greece
Georgios Zampetas
4th Department of Internal Medicine, University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens, 1 Rimini Str., Chaidari, 12462 Athens, Greece
Ourania Efstratiadou
4th Department of Internal Medicine, University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens, 1 Rimini Str., Chaidari, 12462 Athens, Greece
Katerina Chavatza
4th Department of Internal Medicine, University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens, 1 Rimini Str., Chaidari, 12462 Athens, Greece
Dimitra Kavatha
4th Department of Internal Medicine, University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens, 1 Rimini Str., Chaidari, 12462 Athens, Greece
Anastasia Antoniadou
4th Department of Internal Medicine, University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens, 1 Rimini Str., Chaidari, 12462 Athens, Greece
Antonios Papadopoulos
4th Department of Internal Medicine, University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens, 1 Rimini Str., Chaidari, 12462 Athens, Greece
Introduction: Currently approved SARS-CoV-2 vaccines have been proven effective in protecting against severe COVID-19; however, they show variable efficacy against symptomatic infection and disease transmission. We studied the breakthrough COVID-19 infection (BTI) after booster vaccination against SARS-CoV-2 in people living with HIV (PWH). Methods: This was a retrospective, single-center, descriptive cohort study involving PWH, who were followed in the HIV Clinic of “Attikon” University Hospital in Athens, Greece. A BTI was defined as a case of laboratory-confirmed COVID-19 occurring at least 14 days after the third (booster) vaccine dose. Results: We studied 733 PWH [males: 89%, mean age: 45.2 ± 11.3 years, mean BMI: 26.1 ± 4.1, HIV stage at diagnosis (CDC classification): A/B/C = 80/9/11%, MSM: 72.6%] with well-controlled HIV infection. At least one comorbidity was recorded in 54% of cases. A history of ≥1 vaccination was reported by 90%, with 75% having been vaccinated with ≥3 vaccines. Four hundred and two (55%) PWH had a history of COVID-19 and 302 (41.2%) had a BTI, with only 15 (3.7%) needing hospitalization. Only one patient was admitted to the ICU, and no death was reported. Regarding BTI after booster dose, increased age (OR = 0.97, 95% CI: 0.96–0.99, per 1-year increase), and COVID-19 infection prior to booster dose (OR = 0.38, 95% CI: 0.21–0.68) were associated with a lower likelihood for BTI, whereas higher BMI (OR = 1.04, 95% CI: 1.01–1.08) and MSM as a mode of HIV transmission were associated with increased risk (OR = 2.59, 95% CI: 1.47–4.56). The incidence rate of total COVID-19 and BTI followed the epidemic curve of the general population, with the highest incidence recorded in June 2022. Conclusions: A significant proportion of PWH with well-controlled HIV infection experienced a BTI, with the majority of them having mild infection. These data, which include the period of Omicron variant predominance, confirm the importance of vaccination in the protection against severe COVID-19.
