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While vaccines are effective, risk and severity of COVID-19 breakthrough infections are higher in people with vs without HIV. Little is known about the effects of SARS-CoV-2 on CD4 counts among PWH after a breakthrough infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We evaluated the impact of COVID-19 breakthrough infection on immediate (0\u201360 days) and short-term (61\u2013180 days) CD4 count from 2020 to 2022 among PWH vaccinated for COVID-19 in the CIVETs-II study (Corona-Infectious-Virus Epidemiology Team). We utilized paired t tests to test for statistically significant changes in CD4 count before and after breakthrough infection and linear mixed effect models to quantify changes in CD4 count following SARS-CoV-2 breakthrough infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 152 PWH, 37% were White and 40% were \u226555 years of age. Median CD4 count prebreakthrough was 614\u2005cells\/mm3, while median postbreakthrough CD4 count was 612\u2005cells\/mm3. Most patients had an undetectable HIV viral load (62%). Paired t tests indicated no change in CD4 count prior to breakthrough infection as compared with CD4 count 0 to 60 days (\u221240 cells\/mm3; 95% CI, \u221286 to 5), or \u226561 days (25 cells\/mm3; 95% CI, \u221211 to 61). Longitudinal trajectories indicated CD4 count rebound \u226561 days following breakthrough infection (112-cell\/mm3 increase per 60-day increase, P &amp;lt; .05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>While changes in CD4 counts were observed after breakthrough infection, these results are likely not clinically significant, suggesting that among PWH vaccinated for COVD-19, CD4 count is not substantially affected by breakthrough infections.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofag284","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T11:44:42Z","timestamp":1778067882000},"source":"Crossref","is-referenced-by-count":0,"title":["Impact of SARS-CoV-2 Breakthrough Infection on Short-Term CD4 Count Among Adults With HIV in the United States From 2020 to 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of Medicine and Rollins School of Public Health, Emory University , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0268-4680","authenticated-orcid":false,"given":"Raynell","family":"Lang","sequence":"additional","affiliation":[{"name":"University of Calgary Cumming School of Medicine, , Calgary, Alberta ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6971-7646","authenticated-orcid":false,"given":"Michael A","family":"Horberg","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Mid-Atlantic States, Mid-Atlantic Permanente Research Institute , Washington, DC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9032-3713","authenticated-orcid":false,"given":"Sonia","family":"Napravnik","sequence":"additional","affiliation":[{"name":"University of North Carolina at 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