{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T18:42:25Z","timestamp":1791225745966,"version":"4.1.0"},"reference-count":65,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T00:00:00Z","timestamp":1747094400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institutes of Health, the National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["U01DA040381"],"award-info":[{"award-number":["U01DA040381"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institutes of Health, the National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["3U01DA040381-05S2"],"award-info":[{"award-number":["3U01DA040381-05S2"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institutes of Health, the National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["U01MD017423"],"award-info":[{"award-number":["U01MD017423"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","award":["U01DA040381"],"award-info":[{"award-number":["U01DA040381"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","award":["3U01DA040381-05S2"],"award-info":[{"award-number":["3U01DA040381-05S2"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","award":["U01MD017423"],"award-info":[{"award-number":["U01MD017423"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background: Understanding immune response is essential for preparing for public health crises. COVID-19 vaccination provides robust immunity against SARS-CoV-2, but immunocompromised populations may have weaker immune responses. We assessed SARS-CoV-2 spike (trimer) total IgG\/IgM\/IgA (total Ig) to investigate immune response to COVID-19 vaccination in people living with HIV (PLWH), considering CD4+ T cell count, viral load, substance use, and comorbidities. Methods: This cross-sectional study was conducted in Miami, Florida, between May 2021 and December 2021 as part of the NIH Rapid Acceleration of Diagnostics-Underserved Populations (RADx-UP) initiative (3U01DA040381-05S1) and the Miami Adult Studies on HIV (MASH) cohort (U01DA040381). Blood samples were collected and SARS-CoV-2 spike (trimer) total Ig was quantified. HIV serostatus, viral load, CD4+ T cell count, and COVID-19 vaccinations were abstracted from medical records. Substance use (tobacco, alcohol, and drug use [marijuana, cocaine, heroin, fentanyl, methamphetamine, amphetamine, hallucinogens, ecstasy, or misuse of prescription drugs]), and comorbidities (hypertension, diabetes, autoimmune disease, obesity, chronic kidney disease, and substance use disorders) were assessed via validated questionnaires. Drug use was confirmed via urine toxicology. Multivariable linear regression was conducted. Results: Median age (n = 1317) was 57.8 years, 49.8% were male, 50% were Black non-Hispanic, 66.2% had received \u22651 dose of a COVID-19 vaccine, and 29.6% were PLWH (71.3% virally suppressed and median CD4+ T cell count &gt; 500 cells\/\u00b5L). PLWH, compared to people without HIV, were more likely to have received \u22651 dose of a COVID-19 vaccine (76.2% vs. 62.0%, p &lt; 0.001) and present with substance use (77.2% vs. 42.9%, p &lt; 0.001) and comorbidities (72.8% vs. 48.2%, p &lt; 0.001). Vaccinated PLWH, compared to unvaccinated PLWH, had higher CD4+ T cell counts (577.5 vs. 517.5, p = 0.011) and were more likely to be virally suppressed (76.4% vs. 54.8%, p &lt; 0.001). A lower CD4+ T cell count (&lt;200 vs. \u2265500, \u03b2 = \u22120.400, p = 0.033) and higher HIV viral load (\u2265200\u2013&lt;5000 vs. &lt;200, \u03b2 = \u22120.275, p &lt; 0.001) were associated with lower spike (trimer) total Ig titers, indicating a diminished response to COVID-19 vaccination. Conclusions: A lower CD4+ T cell count and higher HIV viremia were linked to reduced SARS-CoV-2 immunogenicity in racial\/ethnic minority PLWH, a population underrepresented in vaccine clinical trials. HIV care providers should target efforts to maintain viral suppression to avoid diminished responses to COVID-19 vaccination.<\/jats:p>","DOI":"10.3390\/vaccines13050517","type":"journal-article","created":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T09:26:48Z","timestamp":1747128408000},"page":"517","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["SARS-CoV-2 Antibodies in Response to COVID-19 Vaccination in Underserved Racial\/Ethnic Minority People Living with HIV"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8736-7002","authenticated-orcid":false,"given":"Yongjun","family":"Huang","sequence":"first","affiliation":[{"name":"Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL 33199, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1850-7390","authenticated-orcid":false,"given":"Haley R.","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL 33199, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Acuna","sequence":"additional","affiliation":[{"name":"Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL 33199, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wensong","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Mathematics and Statistics, College of Arts, Sciences & Education, Florida International University, Miami, FL 33199, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuexia","family":"Wang","sequence":"additional","affiliation":[{"name":"Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL 33199, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9212-8102","authenticated-orcid":false,"given":"Samantha","family":"Gonzales","sequence":"additional","affiliation":[{"name":"Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL 33199, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Barbieri","sequence":"additional","affiliation":[{"name":"Department of Biological Sciences, College of Arts, Sciences & Education, Florida International University, Miami, FL 33199, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5361-6664","authenticated-orcid":false,"given":"David R.","family":"Brown","sequence":"additional","affiliation":[{"name":"Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6577-685X","authenticated-orcid":false,"given":"Marianna K.","family":"Baum","sequence":"additional","affiliation":[{"name":"Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL 33199, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e26573","DOI":"10.1097\/MD.0000000000026573","article-title":"HIV infection and risk of COVID-19 mortality: A meta-analysis","volume":"100","author":"Dong","year":"2021","journal-title":"Medicine"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1111\/hiv.13037","article-title":"Immune deficiency is a risk factor for severe COVID-19 in people living with HIV","volume":"22","author":"Hoffmann","year":"2021","journal-title":"HIV Med."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Ssentongo, P., Heilbrunn, E.S., Ssentongo, A.E., Advani, S., Chinchilli, V.M., Nunez, J.J., and Du, P. 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