Immunologic Interplay Between HIV/AIDS and COVID-19: Adding Fuel to the Flames?

IF 3.7 2区医学 Q2 INFECTIOUS DISEASES

Current HIV/AIDS Reports Pub Date : 2023-04-01 Epub Date: 2023-01-21 DOI:10.1007/s11904-023-00647-z

Matteo Augello, Valeria Bono, Roberta Rovito, Camilla Tincati, Giulia Marchetti

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Abstract

Purpose of review: HIV/AIDS and COVID-19 have been the major pandemics overwhelming our times. Given the enduring immune disfunction featuring people living with HIV (PLWH) despite combination antiretroviral therapy (cART), concerns for higher incidence and severity of SARS-CoV-2 infection as well as for suboptimal responses to the newly developed vaccines in this population arose early during the pandemics. Herein, we discuss the complex interplay between HIV and SARS-CoV-2, with a special focus on the immune responses to SARS-CoV-2 natural infection and vaccination in PLWH.

Recent findings: Overall, current literature shows that COVID-19 severity and outcomes may be worse and immune responses to infection or vaccination lower in PLWH with poor CD4 + T-cell counts and/or uncontrolled HIV viremia. Data regarding the risk of post-acute sequelae of SARS-CoV-2 infection (PASC) among PLWH are extremely scarce, yet they seem to suggest a higher incidence of such condition. Scarce immunovirological control appears to be the major driver of weak immune responses to SARS-CoV-2 infection/vaccination and worse COVID-19 outcomes in PLWH. Therefore, such individuals should be prioritized for vaccination and should receive additional vaccine doses. Furthermore, given the potentially higher risk of developing long-term sequelae, PLWH who experienced COVID-19 should be ensured a more careful and prolonged follow-up.

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艾滋病毒/艾滋病与新冠肺炎之间的免疫相互作用：火上浇油？

审查目的：艾滋病毒/艾滋病和新冠肺炎是我们时代的主要流行病。考虑到尽管联合抗逆转录病毒疗法（cART）仍存在艾滋病毒感染者（PLWH）的持久免疫功能障碍，在大流行早期，人们就开始担心严重急性呼吸系统综合征冠状病毒2型感染的发病率和严重程度更高，以及对新开发疫苗的反应不理想。在此，我们讨论了HIV和SARS-CoV-2之间的复杂相互作用，特别关注PLWH对SARS-CoV-2自然感染和疫苗接种的免疫反应。最近的研究结果：总体而言，当前文献表明，在CD4较差的PLWH中，新冠肺炎的严重程度和结果可能更糟，对感染或疫苗接种的免疫力较低 + T细胞计数和/或未控制的HIV病毒血症。关于PLWH中严重急性呼吸系统综合征冠状病毒2型感染（PASC）急性后遗症风险的数据极为稀少，但它们似乎表明这种情况的发生率更高。缺乏免疫病毒学控制似乎是PLWH对SARS-CoV-2感染/疫苗接种的免疫反应较弱和新冠肺炎结果恶化的主要驱动因素。因此，这些人应优先接种疫苗，并应获得额外的疫苗剂量。此外，鉴于发生长期后遗症的潜在更高风险，应确保经历新冠肺炎的PLWH进行更仔细和更长时间的随访。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current HIV/AIDS Reports INFECTIOUS DISEASES-

CiteScore

8.10

自引率

2.20%

发文量

期刊介绍： This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of HIV/AIDS. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as antiretroviral therapies, behavioral aspects of management, and metabolic complications and comorbidity. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.