HIV/SARS-CoV-2 co-infection: T cell profile, cytokine dynamics and role of exhausted lymphocytes

Sharov, Konstantin S.

OBJECTIVES: The aim was to investigate if there is a synergy in HIV and COVID-19 in their influence upon human immunity; if there is an exacerbation of HIV patients’ immune status by SARS-CoV-2; and if HIV without ART leads to a more serious COVID-19 course than HIV with a proper antiretroviral therapy (ART). DESIGN: The anonymised blood samplings and clinical data were collected in 47 hospitals, clinics and medical centres in six Russian cities/regions in time range 20 March – 15 June 2020. 376 HIV/COVID-19 patients were studied (171 without ART and 205 with ART). Control group was represented by 382 SARS-CoV-2-positive persons without HIV. Lymphocyte and cytokine amounts were measured by flow cytometry and ELISA. The work is a retrospective study. RESULTS: COVID-19 led to rapid augmenting the process of T-cell exhaustion initially caused by HIV and this T cell degradation was most pronounced in patients without ART. A rise in IL-10 and TGFβ serum concentrations was observed. Diminishing CD4(+)/CD8(+) and Th1/Th2 ratios characteristic for HIV progression was accompanied by a surge in exhausted T-cell count with simultaneous exacerbating COVID-19-related respiratory distress. CONCLUSIONS: HIV without ART may be a very serious comorbidity of COVID-19 whereas immunity of HIV/COVID-19 patients with a proper ART is not generally affected by SARS-CoV-2. HIV-1 and SARS-CoV-2 are likely to exhibit a synergic effect and exhausted T-lymphocyte dynamics may be its effective marker.