HIV status alters disease severity and immune cell responses in β variant SARS-CoV-2 infection wave
Author:
Karim Farina, Gazy Inbal, Cele Sandile, Zungu Yenzekile, Krause Robert, Bernstein Mallory, Ganga Yashica, Rodel Hylton, Mthabela Ntombifuthi, Mazibuko Matilda, Khan Khadija, Muema Daniel, Ramjit Dirhona, Ndung’u ThumbiORCID, Hanekom WillemORCID, Gosnell Bernadett I.ORCID, Lessells Richard, Wong Emily, de Oliveira TulioORCID, Moosa Mahomed-Yunus S.ORCID, Lustig Gila, Leslie AlasdairORCID, Kløverpris HenrikORCID, Sigal AlexORCID,
Abstract
AbstractThere are conflicting reports on the effects of HIV on COVID-19. Here we analyzed disease severity and immune cell changes during and after SARS-CoV-2 infection in 236 participants from South Africa, of which 39% were people living with HIV (PLWH), during the first and second (β dominated) infection waves. The second wave had more PLWH requiring supplemental oxygen relative to HIV negative participants. Higher disease severity was associated with low CD4 T cell counts and higher neutrophil to lymphocyte ratios (NLR). Yet, CD4 counts recovered and NLR stabilized after SARS-CoV-2 clearance in wave 2 infected PLWH, arguing for an interaction between SARS-CoV-2 and HIV infection leading to low CD4 and high NLR. The first infection wave, where severity in HIV negative and PLWH was similar, still showed some HIV modulation of SARS-CoV-2 immune responses. Therefore, HIV infection can synergize with the SARS-CoV-2 variant to change COVID-19 outcomes.
Publisher
Cold Spring Harbor Laboratory
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