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Lower SARS-CoV-2–specific humoral immunity in people living with HIV-1 recovered from nonhospitalized COVID-19
Daniel J. Schuster, Shelly Karuna, Caroline Brackett, Martina Wesley, Shuying S. Li, Nathan Eisel, DeAnna Tenney, Sir’Tauria Hilliard, Nicole L. Yates, Jack R. Heptinstall, LaTonya D. Williams, Xiaoying Shen, Robert Rolfe, Robinson Cabello, Lu Zhang, Sheetal Sawant, Jiani Hu, April Kaur Randhawa, Ollivier Hyrien, John A. Hural, Lawrence Corey, Ian Frank, Georgia D. Tomaras, Kelly E. Seaton, HVTN 405/HPTN 1901 Study Team
Daniel J. Schuster, Shelly Karuna, Caroline Brackett, Martina Wesley, Shuying S. Li, Nathan Eisel, DeAnna Tenney, Sir’Tauria Hilliard, Nicole L. Yates, Jack R. Heptinstall, LaTonya D. Williams, Xiaoying Shen, Robert Rolfe, Robinson Cabello, Lu Zhang, Sheetal Sawant, Jiani Hu, April Kaur Randhawa, Ollivier Hyrien, John A. Hural, Lawrence Corey, Ian Frank, Georgia D. Tomaras, Kelly E. Seaton, HVTN 405/HPTN 1901 Study Team
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Research Article AIDS/HIV COVID-19

Lower SARS-CoV-2–specific humoral immunity in people living with HIV-1 recovered from nonhospitalized COVID-19

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Abstract

People living with HIV-1 (PLWH) exhibit more rapid antibody decline following routine immunization and elevated baseline chronic inflammation than people without HIV-1 (PWOH), indicating potential for diminished humoral immunity during SARS-CoV-2 infection. Conflicting reports have emerged on the ability of PLWH to maintain humoral protection against SARS-CoV-2 coinfection during convalescence. It is unknown whether peak COVID-19 severity, along with HIV-1 infection status, associates with the quality and quantity of humoral immunity following recovery. Using a cross-sectional observational cohort from the United States and Peru, adults were enrolled 1–10 weeks after SARS-CoV-2 infection diagnosis or symptom resolution. Serum antibodies were analyzed for SARS-CoV-2–specific response rates, binding magnitudes, ACE2 receptor blocking, and antibody-dependent cellular phagocytosis. Overall, (a) PLWH exhibited a trend toward decreased magnitude of SARS-CoV-2–specific antibodies, despite modestly increased overall response rates when compared with PWOH; (b) PLWH recovered from symptomatic outpatient COVID-19 had comparatively diminished immune responses; and (c) PLWH lacked a corresponding increase in SARS-CoV-2 antibodies with increased COVID-19 severity when asymptomatic versus symptomatic outpatient disease was compared.

Authors

Daniel J. Schuster, Shelly Karuna, Caroline Brackett, Martina Wesley, Shuying S. Li, Nathan Eisel, DeAnna Tenney, Sir’Tauria Hilliard, Nicole L. Yates, Jack R. Heptinstall, LaTonya D. Williams, Xiaoying Shen, Robert Rolfe, Robinson Cabello, Lu Zhang, Sheetal Sawant, Jiani Hu, April Kaur Randhawa, Ollivier Hyrien, John A. Hural, Lawrence Corey, Ian Frank, Georgia D. Tomaras, Kelly E. Seaton, HVTN 405/HPTN 1901 Study Team

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Figure 3

SARS-CoV-2 2P spike–specific percentage ACE2 receptor blocking by serum at enrollment as a function of HIV serostatus and peak COVID-19 symptom severity.

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SARS-CoV-2 2P spike–specific percentage ACE2 receptor blocking by serum ...
Colored dots, positive responders; gray triangles, nonresponders. Box plots represent the distribution for positive responders only. (A) Response rates and the number tested are above each box plot (red, PWOH; blue, PLWH). (B) Response rates are above each box plot. Peak COVID-19 symptom severity is listed as: blue, asymptomatic; red, symptomatic outpatient; teal, hospitalized. No significant differences were detected between PLWH and PWOH. However, percentage blocking increased for hospitalized PWOH compared with symptomatic outpatient PWOH (OR 3.37, P = 0.005). Logistic regression adjusting for peak COVID-19 symptom severity, diabetes, hypertension, COPD/emphysema/asthma, current and ever smoking, age, sex, BMI, race/ethnicity, region, and days since SARS-CoV-2 diagnosis was used. Asterisks and solid lines denote significant differences at P ≤ 0.05 level. For within-group significant differences between peak COVID-19 symptom severities, see Supplemental Table 5.

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