Characterization of humoral and SARS-CoV-2 specific T cell responses in people living with HIV

Understanding the pathology and immunological response to SARS CoV2 infection in specific patient groups is essential for informing the scientific and clinical handling of infections within these patient populations. Here the authors characterise the adaptive immune response to SARS-CoV2 infection in people living with HIV. There is an urgent need to understand the nature of immune responses against SARS-CoV-2, to inform risk-mitigation strategies for people living with HIV (PLWH). Here we show that the majority of PLWH with ART suppressed HIV viral load, mount a detectable adaptive immune response to SARS-CoV-2. Humoral and SARS-CoV-2-specific T cell responses are comparable between HIV-positive and negative subjects and persist 5-7 months following predominately mild COVID-19 disease. T cell responses against Spike, Membrane and Nucleoprotein are the most prominent, with SARS-CoV-2-specific CD4 T cells outnumbering CD8 T cells. We further show that the overall magnitude of SARS-CoV-2-specific T cell responses relates to the size of the naive CD4 T cell pool and the CD4:CD8 ratio in PLWH. These findings suggest that inadequate immune reconstitution on ART, could hinder immune responses to SARS-CoV-2 with implications for the individual management and vaccine effectiveness in PLWH.

Automated summary

The majority of people living with HIV on ART have detectable adaptive immune responses to SARS-CoV-2, with comparable humoral and T cell responses to HIV-negative subjects. T cell responses against Spike, Membrane and Nucleoprotein are prominent in both groups, with CD4 T cells outnumbering CD8 T cells. The magnitude of SARS-CoV-2-specific T cell responses is related to the size of the naive CD4 T cell pool and the CD4:CD8 ratio in people living with HIV, potentially impacting vaccine effectiveness and individual management.