{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T09:42:18Z","timestamp":1791538938106,"version":"4.3.4"},"reference-count":38,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T00:00:00Z","timestamp":1745884800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Thai AIDS Society"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>People living with HIV (PLWH) exhibit heterogeneous immune responses, influenced by varying degrees of immune deficiency and viral suppression. The efficacy of COVID-19 vaccines in this population remains underexplored, particularly in those with low CD4 counts. This study assessed the antibody response in PLWH with CD4 T-cell levels \u2264200 cells\/mm<jats:sup>3<\/jats:sup> compared to those with higher levels, following a bivalent mRNA COVID-19 vaccine booster. All participants were on effective Antiretroviral therapy (ART) with virologic suppression and had received the booster more than a year after their last vaccination. Participants with lower CD4 counts exhibited reduced baseline Anti-RBD IgG titers. However, significant increases in Anti-RBD IgG and surrogate virus neutralization test (sVNT) levels were observed across both CD4 groups post-booster. Despite lower Geometric mean titer (GMT) in the low CD4 group, this group achieved a higher post-boost Anti-RBD IgG Geometric mean ratio (GMR), indicating a robust vaccine response facilitated by effective ART. Nonetheless, cross-neutralization against the circulating XBB variant was limited. Although individuals in the low CD4 group exhibited reduced protection at baseline, they showed significant increase in Anti-RBD IgG and sVNT levels across all CD4 counts after receiving the bivalent COVID vaccine booster.<\/jats:p>","DOI":"10.1371\/journal.pone.0317940","type":"journal-article","created":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T18:11:12Z","timestamp":1745950272000},"page":"e0317940","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Differential immunogenicity in people living with HIV with varying CD4 levels after bivalent mRNA COVID-19 booster 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