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Microorganisms . SARS-CoV-2 Evolution and Spike-Specific CD4+ T-Cell Response in Persistent COVID-19 with Severe HIV Immune Suppression

tetano

Editor, Senior Moderator
Microorganisms


. 2022 Jan 11;10(1):143.
doi: 10.3390/microorganisms10010143.
SARS-CoV-2 Evolution and Spike-Specific CD4+ T-Cell Response in Persistent COVID-19 with Severe HIV Immune Suppression


Hortensia Álvarez[SUP] 1 [/SUP], Ezequiel Ruiz-Mateos[SUP] 2 [/SUP], Pedro Miguel Juiz-González[SUP] 3 [/SUP], Joana Vitallé[SUP] 2 [/SUP], Irene Viéitez[SUP] 4 [/SUP], María Del Carmen Vázquez-Friol[SUP] 5 [/SUP], Isabel Torres-Beceiro[SUP] 3 [/SUP], Alberto Pérez-Gómez[SUP] 2 [/SUP], Pilar Gallego-García[SUP] 6 7 [/SUP], Nuria Estévez-Gómez[SUP] 6 7 [/SUP], Loretta De Chiara[SUP] 6 7 [/SUP], Eva Poveda[SUP] 4 [/SUP], David Posada[SUP] 6 7 [/SUP], Josep M Llibre[SUP] 8 [/SUP]



Affiliations

Abstract

Intra-host evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been reported in cases with persistent coronavirus disease 2019 (COVID-19). In this study, we describe a severely immunosuppressed individual with HIV-1/SARS-CoV-2 coinfection with a long-term course of SARS-CoV-2 infection. A 28-year-old man was diagnosed with HIV-1 infection (CD4+ count: 3 cells/µL nd 563000 HIV-1 RNA copies/mL) and simultaneous Pneumocystis jirovecii pneumonia, disseminated Mycobacterium avium complex infection and SARS-CoV-2 infection. SARS-CoV-2 real-time reverse transcription polymerase chain reaction positivity from nasopharyngeal samples was prolonged for 15 weeks. SARS-CoV-2 was identified as variant Alpha (PANGO lineage B.1.1.7) with mutation S:E484K. Spike-specific T-cell response was similar to HIV-negative controls although enriched in IL-2, and showed disproportionately increased immunological exhaustion marker levels. Despite persistent SARS-CoV-2 infection, adaptive intra-host SARS-CoV-2 evolution, was not identified. Spike-specific T-cell response protected against a severe COVID-19 outcome and the increased immunological exhaustion marker levels might have favoured SARS-CoV-2 persistence.

Keywords: CD4+ T cell response; HIV; SARS-CoV-2.
 
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