Liu Aimei, Wei Jie, Xu Yuanlong, Huang Dayong, Lv Kangyan, Meng Zhihao, Huang Junli, Huang Liling, Wu Guowei
Department of Infectious Diseases, Longtan Hospital of Guangxi Zhuang Autonomous Region, Liuzhou, China.
Infectious Disease Medical Quality Control Center, Guangxi, China.
SAGE Open Med Case Rep. 2021 Jun 16;9:2050313X211014958. doi: 10.1177/2050313X211014958. eCollection 2021.
Since its first appearance in Wuhan, China, severe acute respiratory syndrome coronavirus 2 has rapidly spread throughout the world and has become a global pandemic. It remains unclear whether people living with human immunodeficiency virus are at an increased risk of coronavirus disease 2019 and severe disease manifestation; until now, the evidence regarding the outcomes from severe acute respiratory syndrome coronavirus 2 infection in people living with human immunodeficiency virus is still limited and conflicting. The clinical characteristics of seven patients of family cluster-onset coronavirus disease 2019 were reported, including the immune characteristics of one patient of human immunodeficiency virus/severe acute respiratory syndrome coronavirus 2 coinfection. In the patients of human immunodeficiency virus/severe acute respiratory syndrome coronavirus 2 coinfection, about 2 weeks after infection, it was observed that CD4 and CD8 count showed a downward trend and that of CD8 is more obvious; at the same time, lymphocytes showed a slight increase. CD4, CD8, and lymphocytes are in the plateau period from the second week to the fourth week. About 4 weeks after infection, all showed an increase, in which anti-coronavirus combined with antiviral therapy were given. The time for Nucleic Acid Testing to present as negative was 51 days. The other six patients in the family were non-human immunodeficiency virus infected, the familial cluster received parallel treatment, and the median time for the Nucleic Acid Testing to present as negative was 29 days. The patient of human immunodeficiency virus/severe acute respiratory syndrome coronavirus 2 coinfection presents an immune state of CD4's and CD8's dual lymphatic depletion. Human immunodeficiency virus should still be regarded as an important factor in future risk stratification models for coronavirus disease 2019.
自严重急性呼吸综合征冠状病毒2首次在中国武汉出现以来，它已迅速在全球传播并成为全球大流行疾病。目前尚不清楚人类免疫缺陷病毒感染者感染2019冠状病毒病及出现严重疾病表现的风险是否增加；直到现在，关于人类免疫缺陷病毒感染者感染严重急性呼吸综合征冠状病毒2的结果的证据仍然有限且相互矛盾。本文报告了7例家庭聚集性发病的2019冠状病毒病患者的临床特征，包括1例人类免疫缺陷病毒/严重急性呼吸综合征冠状病毒2合并感染患者的免疫特征。在人类免疫缺陷病毒/严重急性呼吸综合征冠状病毒2合并感染患者中，感染后约2周，观察到CD4和CD8计数呈下降趋势，且CD8下降更明显；同时，淋巴细胞略有增加。CD4、CD8和淋巴细胞在第二周至第四周处于平台期。感染后约4周，所有指标均升高，其中给予了抗冠状病毒联合抗病毒治疗。核酸检测呈阴性的时间为51天。家庭中的其他6名患者未感染人类免疫缺陷病毒，该家庭聚集性病例接受了平行治疗，核酸检测呈阴性的中位时间为29天。人类免疫缺陷病毒/严重急性呼吸综合征冠状病毒2合并感染患者呈现CD4和CD8双淋巴细胞耗竭的免疫状态。在未来的2019冠状病毒病风险分层模型中，人类免疫缺陷病毒仍应被视为一个重要因素。
