People living with HIV have impaired immune responses to certain pathogens and immunizations, and during the COVID-19 pandemic, they often experienced severe symptoms if they became infected with SARS-CoV-2. New research led by investigators at Massachusetts General Hospital (MGH), a founding member of Mass General Brigham (MGB), examines how patient characteristics and COVID-19 infection can affect the antibody responses of people with HIV — including antibody responses. Anti SARS. -CoV-2 proteins as well as proteins from other viruses such as cytomegalovirus (CMV) and Epstein-Barr virus (EBV).
The study published in JCI Insight, included data from the Global Randomized Trial for the Prevention of Vascular Events in HIV (REPRIEVE), a large ongoing cardiovascular prevention trial testing the effects of statins in HIV-positive subjects on ART that collected information regarding the diagnosis of COVID-19, its symptoms, and adverse events every four months starting in April 2020. (Participants vaccinated against SARS-CoV-2 were excluded.) Investigators also used a new platform to evaluate different types of non-SARS-CoV-2 and SARS-CoV-2 antibodies. CoV-2 present. in the blood of 2,464 participants.
“We asked whether COVID-19 infection affected the antibody response to proteins other than SARS-CoV-2 — in this case proteins from CMV and EBV. We also asked about the effect of host factors on antibody responses to SARS-CoV-2 among COVID-19 infected participants,” says senior author Stephen Grinspoon, MD, chief of the metabolomics unit at MGH and director of the Harvard Nutritional Obesity Research Center.
In the overall analysis, COVID-19 infection was associated with elevated antibody responses to CMV and EBV. Among participants with COVID, a higher BMI was associated with an amplified response to SARS-CoV-2, and a lower CD4+ T cell count (the lowest number of CD4+ T cells a person has) was associated with an ineffective or poorly functioning antibody response. to SARS-CoV-2.
“Higher responses to EBV and CMV in people with COVID-19 may indicate increased susceptibility to or as a result of persistent inflammation, and the abnormal repertoire seen among those with obesity could herald an increased inflammatory response in this group,” says Grinspoon. . “The association with nadir CD4 and increased immune response to COVID was interesting because nadir CD4 is a marker of immune function and suggests a major association between HIV-related immune function and abnormal immune responses to COVID.”
As the REPRIEVE trial continues and data is generated regarding the effects of statins on the acquisition and severity of COVID-19 and long-term COVID-19 in people with HIV, Grinspoon and colleagues anticipate that their novel antibody platform may provide new mechanistic insights in the short term. and long-term complications of SARS-CoV-2 infection.
Co-authors are Samuel R. Schnittman, Wonyoung Jung, Kathleen F. Fitch, Marcella F. Zane, Sarah McCallum, Jessica Shih-Lo Lee, Sally Chen, Brandon J. Davies, Evelyn S. Fulda, Marissa R. Diggs, Françoise Geigel, Romina Chinchai, and Anandi N. Sheth, and Carl J.
This study was supported by the National Institutes of Health, as well as Kowa Pharmaceuticals, Gilead Sciences, and ViiV Healthcare.
