Africa Health Research Institute, Nelson R. Mandela School of Medicine, University of Kwa-Zulu Natal, Durban, South Africa.
HIV Pathogenesis Program, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa.
Elife. 2022 Jul 26;11:e78374. doi: 10.7554/eLife.78374.
In some instances, unsuppressed HIV has been associated with severe COVID-19 disease, but the mechanisms underpinning this susceptibility are still unclear. Here, we assessed the impact of HIV infection on the quality and epitope specificity of SARS-CoV-2 T cell responses in the first wave and second wave of the COVID-19 epidemic in South Africa. Flow cytometry was used to measure T cell responses following peripheral blood mononuclear cell stimulation with SARS-CoV-2 peptide pools. Culture expansion was used to determine T cell immunodominance hierarchies and to assess potential SARS-CoV-2 escape from T cell recognition. HIV-seronegative individuals had significantly greater CD4 T cell responses against the Spike protein compared to the viremic people living with HIV (PLWH). Absolute CD4 count correlated positively with SARS-CoV-2-specific CD4 and CD8 T cell responses (CD4 r=0.5, p=0.03; CD8 r=0.5, p=0.001), whereas T cell activation was negatively correlated with CD4 T cell responses (CD4 r=-0.7, p=0.04). There was diminished T cell cross-recognition between the two waves, which was more pronounced in individuals with unsuppressed HIV infection. Importantly, we identify four mutations in the Beta variant that resulted in abrogation of T cell recognition. Taken together, we show that unsuppressed HIV infection markedly impairs T cell responses to SARS-Cov-2 infection and diminishes T cell cross-recognition. These findings may partly explain the increased susceptibility of PLWH to severe COVID-19 and also highlights their vulnerability to emerging SARS-CoV-2 variants of concern.
在某些情况下,未受抑制的 HIV 与严重的 COVID-19 疾病有关,但支持这种易感性的机制仍不清楚。在这里,我们评估了 HIV 感染对南非 COVID-19 疫情第一波和第二波中 SARS-CoV-2 T 细胞反应的质量和表位特异性的影响。我们使用流式细胞术测量了外周血单核细胞刺激 SARS-CoV-2 肽库后 T 细胞的反应。培养扩增用于确定 T 细胞免疫优势层次,并评估潜在的 SARS-CoV-2 逃避 T 细胞识别。与 HIV 病毒载量的 HIV 血清阴性个体相比,HIV 血清阴性个体对 Spike 蛋白的 CD4 T 细胞反应显著更大。绝对 CD4 计数与 SARS-CoV-2 特异性 CD4 和 CD8 T 细胞反应呈正相关(CD4 r=0.5,p=0.03;CD8 r=0.5,p=0.001),而 T 细胞激活与 CD4 T 细胞反应呈负相关(CD4 r=-0.7,p=0.04)。两次波之间的 T 细胞交叉识别减少,在未受抑制的 HIV 感染个体中更为明显。重要的是,我们在 Beta 变体中发现了四个导致 T 细胞识别丧失的突变。总之,我们表明,未受抑制的 HIV 感染显著损害了对 SARS-CoV-2 感染的 T 细胞反应,并降低了 T 细胞交叉识别。这些发现可能部分解释了 HIV 感染者对严重 COVID-19 的易感性增加,也突出了他们对新兴 SARS-CoV-2 变体的脆弱性。