Africa Health Research Institute, Durban, South Africa.
School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa.
Elife. 2021 Oct 5;10:e67397. doi: 10.7554/eLife.67397.
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.
关于 HIV 对 COVID-19 的影响,目前存在相互矛盾的报告。在这里,我们分析了南非 236 名参与者在 SARS-CoV-2 感染期间和之后的疾病严重程度和免疫细胞变化,其中 39%为 HIV 感染者(PLWH),分别处于第一波和第二波(Beta 主导)感染中。第二波中需要补充氧气的 PLWH 相对 HIV 阴性参与者更多。更高的疾病严重程度与较低的 CD4 T 细胞计数和较高的中性粒细胞与淋巴细胞比值(NLR)相关。然而,在第二波感染的 PLWH 中,SARS-CoV-2 清除后,CD4 计数恢复且 NLR 稳定,这表明 SARS-CoV-2 和 HIV 感染之间存在相互作用,导致低 CD4 和高 NLR。在 HIV 阴性和 PLWH 严重程度相似的第一波感染中,仍显示出 HIV 对 SARS-CoV-2 免疫反应的一些调节作用。因此,HIV 感染可以与 SARS-CoV-2 变体协同作用,改变 COVID-19 的结果。