Acute HIV-1 and SARS-CoV-2 Infections Share Slan plus Monocyte Depletion-Evidence from an Hyperacute HIV-1 Case Report

Monocytes are key modulators in acute viral infections, determining both inflammation and development of specific B- and T-cell responses. Recently, these cells were shown to be associated to different SARS-CoV-2 infection outcome. However, their role in acute HIV-1 infection remains unclear. We had the opportunity to evaluate the mononuclear cell compartment in an early hyper-acute HIV-1 patient in comparison with an untreated chronic HIV-1 and a cohort of SARS-CoV-2 infected patients, by high dimensional flow cytometry using an unsupervised approach. A distinct polarization of the monocyte phenotype was observed in the two viral infections, with maintenance of pro-inflammatory M1-like profile in HIV-1, in contrast to the M2-like immunosuppressive shift in SARS-CoV-2. Noticeably, both acute infections had reduced CD14(low/-)CD16(+) non-classical monocytes, with depletion of the population expressing Slan (6-sulfo LacNac), which is thought to contribute to immune surveillance through pro-inflammatory properties. This depletion indicates a potential role of these cells in acute viral infection, which has not previously been explored. The inflammatory state accompanied by the depletion of Slan+ monocytes may provide new insights on the critical events that determine the rate of viral set-point in acute HIV-1 infection and subsequent impact on transmission and reservoir establishment.

Automated summary

Monocytes play crucial roles in acute viral infections, influencing inflammation and the development of specific B- and T-cell responses. A study comparing monocyte phenotypes in HIV-1 and SARS-CoV-2 infected patients found distinct polarization, with HIV-1 maintaining a pro-inflammatory M1-like profile and SARS-CoV-2 showing an M2-like immunosuppressive shift. Both acute infections exhibited decreased levels of CD14(low/-)CD16(+) non-classical monocytes, particularly those expressing Slan, suggesting a potential role of these cells in immune surveillance during viral infections.