COVID-19 in people living with HIV: Clinical implications of dynamics of the immune response to SARS-CoV-2

Autor: Annalisa Mondi, Andrea Antinori, Enrico Girardi, Federico De Zottis, Eleonora Cimini, Chiara Agrati, Giulia Matusali, Roberta Gagliardini, Concetta Castilletti, Francesca Colavita, Vincenzo Schininà, Stefania Cicalini, Vincenzo Puro, Alessandra Vergori, Carmela Pinnetti, Rita Casetti, Giuseppe Ippolito, Markus Maeurer, Valentina Mazzotta, Francesco Vaia, Maria Rosaria Capobianchi
Rok vydání: 2020
Předmět:
Male
medicine.medical_treatment
HIV Infections
Antibodies
Viral
Severity of Illness Index
Immunoglobulin G
Piperazines
immune response
SARS‐CoV‐2
0302 clinical medicine
030212 general & internal medicine
biology
Coinfection
Immunosuppression
Middle Aged
Infectious Diseases
Anti-Retroviral Agents
Cytokines
RNA
Viral
Reverse Transcriptase Inhibitors
030211 gastroenterology & hepatology
Female
Antibody
Heterocyclic Compounds
3-Ring
Risk
Pyridones
Short Communication
Short Communications
Transgender Persons
Proinflammatory cytokine
03 medical and health sciences
Immune system
COVID‐19
Virology
Severity of illness
Oxazines
medicine
Humans
HIV Integrase Inhibitors
Tenofovir
business.industry
SARS-CoV-2
medicine.disease
HIV infection
Antibodies
Neutralizing
CD4 Lymphocyte Count
Immunity
Humoral
COVID-19 Drug Treatment
Pneumonia
Respiratory failure
Immunology
biology.protein
business
Zdroj: Journal of Medical Virology
ISSN: 1096-9071
Popis: Background Little evidence on COVID‐19 in people living with HIV (PLWH) is currently available. Material and Methods We reported clinical and viro‐immunological data of all HIV‐positive patients admitted to our centre with COVID‐19 from March 1 to May 12,2020. Results Overall, five patients were included: all were virologically‐suppressed on antiretroviral therapy and CD4+ count was >350 cell/mm3 in all but two patients. Although all patients had evidence of pneumonia on admission, only one developed respiratory failure. SARS‐CoV‐2‐RNA was never detected from nasopharyngeal swabs in two patients, whereas, in the others, viral clearance occurred within a maximum of 43 days. IgG production was elicited in all patients and neutralizing antibodies in all but one patient. Specific‐T‐cell response developed in all patients but was stronger in those with more severe presentation. Similarly, the highest level of pro‐inflammatory cytokines was found in the only patient experiencing respiratory failure. Despite a mild presentation, patients with more pronounced immunosuppression showed high degrees of both cytokines production and immune‐activation. Conclusions Our study did not find an increased risk and severity of COVID‐19 in PLWH. Adaptative cellular immune response to SARS‐CoV‐2 appeared to correlate to disease severity. The mild clinical picture showed in advanced HIV patients, despite a significant T‐cell activation and inflammatory profile, suggests a potential role of HIV‐driven immunological dysregulation in avoiding immune‐pathogenetic processes. However, other possible explanations, as a protective role of certain antiretroviral drugs, should be considered. Further larger studies are needed to better clarify the impact of HIV infection on COVID‐19. This article is protected by copyright. All rights reserved.
Databáze: OpenAIRE
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