Shingles vaccine works for people with HIV — with one catch

The recombinant zoster vaccine (RZV) is proving its worth in a population that needs it most. A new clinical trial out of South Korea found that people living with HIV (PLWH) mounted strong antibody responses to the shingles vaccine — and CD4 count didn't change that picture. Whether patients had low or high CD4 levels, 100% achieved the humoral vaccine response threshold after two doses.

But there's a nuance worth noting. Cell-mediated immunity — the arm of the immune system that involves T cells — told a different story. PLWH with low CD4 counts had notably weaker cellular responses compared to those without HIV, suggesting the vaccine's full protective potential may not be equally realized across all HIV patients.

By the Numbers:

• 100% humoral vaccine response rate across all groups (low CD4, high CD4, and HIV-negative)
• Cell-mediated response rates: 33.3% (low CD4), 50.0% (high CD4), 80.0% (no HIV)
• 60 virologically suppressed PLWH + 10 HIV-negative participants enrolled
• No grade 3+ adverse events or herpes zoster cases reported during follow-up

Why it matters: PLWH face a higher risk of shingles and its complications. These findings reinforce current guidelines recommending RZV for PLWH regardless of CD4 count — while also flagging that cellular immunity gaps may warrant further study to fully optimize protection in this vulnerable group.