Abstract
While the risk of SARS-CoV-2 infection and/or COVID-19 disease progression in the general population has been largely assessed, its impact on HIV-positive individuals remains unclear. We present clinical and immunological data collected in a cohort of HIV-infected young individuals during the first wave of COVID-19 pandemic. SARS-CoV-2 RNA, virus-specific antibodies, as well as the expression of factors involved in the anti-viral immune response were analyzed. Moreover, we set up an in vitro coinfection assay to study the mechanisms correlated to the coinfection process. Our results did not show any increased risk of severe COVID-19 in HIV-positive young individuals. In those subjects who contracted SARS-CoV-2 infection, an increase in IL-10 expression and production was observed. Furthermore, in the in vitro coinfection assay, we revealed a reduction in SARS-CoV-2 replication associated to an upregulation of IL-10. We speculate that IL-10 could play a crucial role in the course of SARS-CoV-2 infection in HIV-positive individuals. These results might help defining clinical management of HIV/SARS-CoV-2 co-infected young individuals, or putative indications for vaccination schedules in this population.
Highlights
SARS-CoV-2-specific immune responses in young patients are still scarcely described
To study in detail the interaction between the two viruses, we established an in vitro co-culture model involving SARS-CoV-2-infection of Calu-3 cells with peripheral blood mononuclear cells (PBMCs) pre-infected with HIV-1 to investigate their cross-talk during the coinfection process
Several coinfections have the potential to inhibit other coronaviruses replications, such as human coronavirus NL63 [15], and because of the existing infection with HIV-1 interfering with the replication of the hCoV in the same host, it was suggested that the viral load of the hCoV remains low [16]
Summary
It is known that COVID-19 severity grows within age groups, the paucity of data present in literature do not allow one to fully understand the clinical and immunological basis of this phenomenon [1]. Whereas long-term ARV treatment could result in those same chronic comorbidities (including cardiovascular diseases, diabetes, dyslipidemia, renal impairment, and metabolic alteration) that are associated with a more severe COVID-19 course, antivirals were tentatively used in the therapy of COVID-19 [4]. Available results indicate that HIV-positive adult patients affected by COVID-19 exhibit clinical features and a disease course comparable to the one observed in the general population [5,6,7]. Immunological and clinical data on HIV-infected young patients are still sorely missing [7]
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