Clearance of persistent SARS-CoV-2 associates with increased neutralizing antibodies in advanced HIV disease post-ART initiation. Karim, F., Riou, C., Bernstein, M., Jule, Z., Lustig, G., van Graan, S., Keeton, R. S., Upton, J. L., Ganga, Y., Khan, K., Reedoy, K., Mazibuko, M., Govender, K., Thambu, K., Ngcobo, N., Venter, E., Makhado, Z., Hanekom, W., von Gottberg, A., Hoque, M., Karim, Q. A., Abdool Karim, S. S., Manickchund, N., Magula, N., Gosnell, B. I., Lessells, R. J., Moore, P. L., Burgers, W. A., de Oliveira, T., Moosa, M. Y. S., & Sigal, A. Nature Communications, 15(1):2360, Nature Publishing Group, mar, 2024. ![Clearance of persistent SARS-CoV-2 associates with increased neutralizing antibodies in advanced HIV disease post-ART initiation [link]](https://bibbase.org/img/filetypes/link.svg "link")
Paper doi abstract bibtex SARS-CoV-2 clearance requires adaptive immunity but the contribution of neutralizing antibodies and T cells in different immune states is unclear. Here we ask which adaptive immune responses associate with clearance of long-term SARS-CoV-2 infection in HIV-mediated immunosuppression after suppressive antiretroviral therapy (ART) initiation. We assembled a cohort of SARS-CoV-2 infected people in South Africa (n = 994) including participants with advanced HIV disease characterized by immunosuppression due to T cell depletion. Fifty-four percent of participants with advanced HIV disease had prolonged SARS-CoV-2 infection (\textgreater1 month). In the five vaccinated participants with advanced HIV disease tested, SARS-CoV-2 clearance associates with emergence of neutralizing antibodies but not SARS-CoV-2 specific CD8 T cells, while CD4 T cell responses were not determined due to low cell numbers. Further, complete HIV suppression is not required for clearance, although it is necessary for an effective vaccine response. Persistent SARS-CoV-2 infection led to SARS-CoV-2 evolution, including virus with extensive neutralization escape in a Delta variant infected participant. The results provide evidence that neutralizing antibodies are required for SARS-CoV-2 clearance in HIV-mediated immunosuppression recovery, and that suppressive ART is necessary to curtail evolution of co-infecting pathogens to reduce individual health consequences as well as public health risk linked with generation of escape mutants. There is limited data on immune factors contributing to SARS-CoV-2 viral clearance in people living with HIV. Here, the authors show that re-emergence of the neutralizing antibody response may be key to clearing persistent SARS-CoV-2 infection in ART-mediated recovery from immunosuppression in advanced HIV disease.
@article{Karim2024,
abstract = {SARS-CoV-2 clearance requires adaptive immunity but the contribution of neutralizing antibodies and T cells in different immune states is unclear. Here we ask which adaptive immune responses associate with clearance of long-term SARS-CoV-2 infection in HIV-mediated immunosuppression after suppressive antiretroviral therapy (ART) initiation. We assembled a cohort of SARS-CoV-2 infected people in South Africa (n = 994) including participants with advanced HIV disease characterized by immunosuppression due to T cell depletion. Fifty-four percent of participants with advanced HIV disease had prolonged SARS-CoV-2 infection ({\textgreater}1 month). In the five vaccinated participants with advanced HIV disease tested, SARS-CoV-2 clearance associates with emergence of neutralizing antibodies but not SARS-CoV-2 specific CD8 T cells, while CD4 T cell responses were not determined due to low cell numbers. Further, complete HIV suppression is not required for clearance, although it is necessary for an effective vaccine response. Persistent SARS-CoV-2 infection led to SARS-CoV-2 evolution, including virus with extensive neutralization escape in a Delta variant infected participant. The results provide evidence that neutralizing antibodies are required for SARS-CoV-2 clearance in HIV-mediated immunosuppression recovery, and that suppressive ART is necessary to curtail evolution of co-infecting pathogens to reduce individual health consequences as well as public health risk linked with generation of escape mutants. There is limited data on immune factors contributing to SARS-CoV-2 viral clearance in people living with HIV. Here, the authors show that re-emergence of the neutralizing antibody response may be key to clearing persistent SARS-CoV-2 infection in ART-mediated recovery from immunosuppression in advanced HIV disease.},
author = {Karim, Farina and Riou, Catherine and Bernstein, Mallory and Jule, Zesuliwe and Lustig, Gila and van Graan, Strauss and Keeton, Roanne S. and Upton, Janine Lee and Ganga, Yashica and Khan, Khadija and Reedoy, Kajal and Mazibuko, Matilda and Govender, Katya and Thambu, Kershnee and Ngcobo, Nokuthula and Venter, Elizabeth and Makhado, Zanele and Hanekom, Willem and von Gottberg, Anne and Hoque, Monjurul and Karim, Quarraisha Abdool and {Abdool Karim}, Salim S. and Manickchund, Nithendra and Magula, Nombulelo and Gosnell, Bernadett I. and Lessells, Richard J. and Moore, Penny L. and Burgers, Wendy A. and de Oliveira, Tulio and Moosa, Mahomed Yunus S. and Sigal, Alex},
doi = {10.1038/s41467-024-46673-2},
file = {:C$\backslash$:/Users/01462563/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Karim et al. - 2024 - Clearance of persistent SARS-CoV-2 associates with increased neutralizing antibodies in advanced HIV disease post-.pdf:pdf},
issn = {2041-1723},
journal = {Nature Communications},
keywords = {2,Antibodies,CoV,Evolutionary genetics,HIV infections,Infection,OA,OA{\_}PMC,SARS,fund{\_}not{\_}ack,original},
mendeley-tags = {OA,OA{\_}PMC,fund{\_}not{\_}ack,original},
month = {mar},
number = {1},
pages = {2360},
pmid = {38491050},
publisher = {Nature Publishing Group},
title = {{Clearance of persistent SARS-CoV-2 associates with increased neutralizing antibodies in advanced HIV disease post-ART initiation}},
url = {https://www.nature.com/articles/s41467-024-46673-2},
volume = {15},
year = {2024}
}
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