eLife (Oct 2021)
HIV status alters disease severity and immune cell responses in Beta variant SARS-CoV-2 infection wave
- Farina Karim,
- Inbal Gazy,
- Sandile Cele,
- Yenzekile Zungu,
- Robert Krause,
- Mallory Bernstein,
- Khadija Khan,
- Yashica Ganga,
- Hylton Rodel,
- Ntombifuthi Mthabela,
- Matilda Mazibuko,
- Daniel Muema,
- Dirhona Ramjit,
- Thumbi Ndung'u,
- Willem Hanekom,
- Bernadett Gosnell,
- COMMIT-KZN Team,
- Richard J Lessells,
- Emily B Wong,
- Tulio de Oliveira,
- Mahomed-Yunus S Moosa,
- Gil Lustig,
- Alasdair Leslie,
- Henrik Kløverpris,
- Alex Sigal
Affiliations
- Farina Karim
- ORCiD
- Africa Health Research Institute, Durban, South Africa; School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
- Inbal Gazy
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa; KwaZulu-Natal Research Innovation and Sequencing Platform, Durban, South Africa
- Sandile Cele
- Africa Health Research Institute, Durban, South Africa; School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
- Yenzekile Zungu
- Africa Health Research Institute, Durban, South Africa
- Robert Krause
- ORCiD
- Africa Health Research Institute, Durban, South Africa; School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
- Mallory Bernstein
- Africa Health Research Institute, Durban, South Africa
- Khadija Khan
- Africa Health Research Institute, Durban, South Africa; School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
- Yashica Ganga
- Africa Health Research Institute, Durban, South Africa
- Hylton Rodel
- Africa Health Research Institute, Durban, South Africa; Division of Infection and Immunity, University College London, London, United Kingdom
- Ntombifuthi Mthabela
- Africa Health Research Institute, Durban, South Africa
- Matilda Mazibuko
- Africa Health Research Institute, Durban, South Africa
- Daniel Muema
- Africa Health Research Institute, Durban, South Africa; School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
- Dirhona Ramjit
- Africa Health Research Institute, Durban, South Africa
- Thumbi Ndung'u
- ORCiD
- Africa Health Research Institute, Durban, South Africa; Division of Infection and Immunity, University College London, London, United Kingdom; HIV Pathogenesis Programme, The Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa; Max Planck Institute for Infection Biology, Berlin, Germany
- Willem Hanekom
- Africa Health Research Institute, Durban, South Africa; Division of Infection and Immunity, University College London, London, United Kingdom
- Bernadett Gosnell
- Department of Infectious Diseases, Nelson R. Mandela School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
- COMMIT-KZN Team
- Richard J Lessells
- ORCiD
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa; KwaZulu-Natal Research Innovation and Sequencing Platform, Durban, South Africa; Centre for the AIDS Programme of Research in South Africa, Durban, South Africa
- Emily B Wong
- Africa Health Research Institute, Durban, South Africa; Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, United States
- Tulio de Oliveira
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa; KwaZulu-Natal Research Innovation and Sequencing Platform, Durban, South Africa; Centre for the AIDS Programme of Research in South Africa, Durban, South Africa; Centre for Epidemic Response and Innovation, School of Data Science and Computational Thinking, Stellenbosch University, Stellenbosch, South Africa; Department of Global Health, University of Washington, Seattle, United States
- Mahomed-Yunus S Moosa
- Department of Infectious Diseases, Nelson R. Mandela School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
- Gil Lustig
- Centre for the AIDS Programme of Research in South Africa, Durban, South Africa
- Alasdair Leslie
- Africa Health Research Institute, Durban, South Africa; School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa; Division of Infection and Immunity, University College London, London, United Kingdom
- Henrik Kløverpris
- Africa Health Research Institute, Durban, South Africa; School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa; Division of Infection and Immunity, University College London, London, United Kingdom; Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
- Alex Sigal
- ORCiD
- Africa Health Research Institute, Durban, South Africa; School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa; Max Planck Institute for Infection Biology, Berlin, Germany
- DOI
- https://doi.org/10.7554/eLife.67397
- Journal volume & issue
-
Vol. 10
Abstract
There 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 (Beta 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.
Keywords
