IMMUNE RESPONSE TO SARS-COV-2 IN PATIENTS WITH CHRONIC HIV INFECTION

Abstract

Introduction. Data for the long-term effects of SARS-CoV-2/HIV co-infection on immune restoration, as well as the level of post-exposure and post-vaccination immunity at the current stage of SARS-CoV-2 pandemic in HIV+ individuals is still scarce. We assessed SARS-CoV-2-specific immune responses, and the effects of SARS-CoV-2 infection on the immune recovery in HIV+cART+ patients with different exposure history.  Materials and methods. HIV+cART+ patients 9 (2-18) months after mild/moderate COVID-19 and completed immunization with anti-SARS-CoV-2 vaccine (n=13, group A), convalescent, not immunized (n=11, group B), or with no history of exposure to SARS-CoV-2 (n=11, group C) were included in the study. CD4AC and CD4/CD8 ratio were determined before and after the documented/probable contact with SARS-CoV-2 by 4-color flow cytometry (TRUCount, MultiTest, FACSCanto II). Virus-specific immunity was characterized by the SARS-CoV-2 specific IFNγ production (SARS-CoV-2 IGRA, Euroimmun) and the levels of RBD-IgG ((Euroimmun ELISA).  Results. SARS-CoV-2 specific T-cell and IgG responses were highly correlated and present, respectively, in 92% and 100%; 64% and 54%, 36% and 50% from group A, B and C patients. SARS-CoV-2 specific IFNy+T cells and RDB-IgG were significantly higher in the group with hybrid exposure (A) as compared to convalescent (B) and asymptomatic (C) patients. No significant difference existed between background and actual CD4AC (mean 836 vs 799 cells/µl, p>0.05, Mann-Whitney), and the CD4/CD8 ratio significantly increased in the group with hybrid exposure (0.92 vs 1.07, p<0.01, paired T-test).  Conclusion. Over 80% of tested HIV+ individuals have mounted a SARS-CoV-2 specific immune response. Immunization and hybrid exposure provide a durable and significantly stronger SARS-CoV-2-specific immune response as compared to mild/ asymptomatic infection, without affecting the long-term immune recovery.