Intra-host evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been reported in cases with persistent coronavirus disease 2019 (COVID-19). In this study, we describe a severely immunosuppressed individual with HIV-1/SARS-CoV-2 coinfection with a long-term course of SARS-CoV-2 infection. A 28-year-old man was diagnosed with HIV-1 infection (CD4+ count: 3 cells/µL nd 563000 HIV-1 RNA copies/mL) and simultaneous Pneumocystis jirovecii pneumonia, disseminated Mycobacterium avium complex infection and SARS-CoV-2 infection. SARS-CoV-2 real-time reverse transcription polymerase chain reaction positivity from nasopharyngeal samples was prolonged for 15 weeks. SARS-CoV-2 was identified as variant Alpha (PANGO lineage B.1.1.7) with mutation S:E484K. Spike-specific T-cell response was similar to HIV-negative controls although enriched in IL-2, and showed disproportionately increased immunological exhaustion marker levels. Despite persistent SARS-CoV-2 infection, adaptive intra-host SARS-CoV-2 evolution, was not identified. Spike-specific T-cell response protected against a severe COVID-19 outcome and the increased immunological exhaustion marker levels might have favoured SARS-CoV-2 persistence.
【저자키워드】 SARS-CoV-2, HIV, CD4+ T cell response, 【초록키워드】 COVID-19, coronavirus disease, Evolution, coronavirus, Mutation, adaptive, severe COVID-19, Pneumonia, SARS-COV-2 infection, T-cell Response, variant, Infection, outcome, RNA, persistence, HIV-1, Control, SARS-CoV-2 evolution, reverse transcription, Lineage B.1.1.7, IL-2, marker, Immunosuppressed, acute respiratory syndrome, HIV-negative, complex, CD4+, Mycobacterium, HIV-1 infection, nasopharyngeal sample, immunological, polymerase chain, Course, reported, diagnosed, 【제목키워드】 COVID-19, response, persistent, suppression, CD4+,