Health
COVID-19 infection is associated with increased cytomegalovirus response in HIV-infected individuals receiving ART
among those who live together HIV (PLWH), people with COVID-19 had higher cytomegalovirus (CMV) responses compared to those without COVID-19. JCI Insight.
This suggests that it could potentially be a result of increased susceptibility or persistent inflammation, the authors said.
To arrive at these findings, they used data from the REPRIEVE trial. The final study cohort included his 2464 HIS REPRIEVE participants, of whom 283 were infected with her COVID-19 and 2181 were not. Antibody positivity was pre-identified based on SARS-CoV-2 receptor binding domain (RBD) IgG and/or IgA >5 SD above plate-specific negative controls using an ELISA assay. Among PLWHs infected with COVID-19, 271 were positive for RBD IgG, 21 were positive for RBD IgA, and 9 were positive for both.
Median age was 53 years, 35% of participants were female, and 68% were non-Caucasian. Median CD4 T cell count was 649 cells/mm3but half had a nadir of CD4 counts <200 cells/mm3All participants were receiving antiretroviral therapy (ART), 53% had been on ART for at least 10 years, and 46% had used an integrase strand transfer inhibitor (INSTI)-based regimen. . Almost all participants were virally suppressed and had CD4 counts <400 copies/mL.
Higher body mass index (BMI) significantly amplified the SARS-CoV-2 response in PLWH infected with COVID-19, suggesting that the inflammatory response in these individuals is exaggerated. says that Furthermore, lower nadir CD4 counts were associated with higher SARS-CoV-2 IgM and FcγRIIB binding capacity, indicating reduced function of extrafollicular and inhibitory responses.
“The observation that SARS-CoV-2-specific IgG4 and FcRIIB binding capacities are not as broadly elevated as in individuals with high BMI and tend to reflect an inhibitory or regulatory response suggests that this BMI-related humoral profile is associated with pathology. suggesting that it may be contributing to the positive response,” the authors said.
The authors found that among PLWHs without COVID-19, female sex, older age, and lower CD4 nadirs were associated with intrinsic alterations in the SARS-CoV-2 humoral immune repertoire. I discovered that
“In this first comprehensive assessment of the humoral repertoire in a global cohort of PWHs, distinct SARS-CoV-2-specific humoral immunity was demonstrated among PWHs with obesity or subminimal CD4+ T cell counts.” We identify profiles and highlight plausible mechanisms associated with the exacerbation of COVID-19-related outcomes in this setting,” the authors said. “Host factors associated with the humoral repertoire of COVID-19 cohorts enhance our understanding of these important changes across PWH.”
These findings in PLWH without COVID-19 suggest that systemic inflammation by pro-inflammatory cytokines like IL-6 may stimulate higher antibody levels or types of antibody responses, but not after antigen exposure. It was consistent with previous observations that the damping of these responses can also be large.
reference
Schnittman SR, Jung W, Fitch KV, et al. Effects of host factors and COVID-19 infection on the humoral immune repertoire of treated HIV. JCI Insight2023;8(5):e166848.doi:10.1172/jci.insight.166848
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