Abstract Rationale: Complex immune dysregulation in interferon (IFN) and T cell response has been observed in human immunodeficiency virus (HIV-1)-infected patients as well as in coronavirus disease-2019 (COVID-19) patients. However, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)/HIV-1 coinfection has been described in only few cases worldwide and no data are available on immunological outcomes in HIV-1-patients infected with SARS-CoV-2. Hence, this study aims to compare type I IFN response and T cell activation levels between a SARS-CoV-2/HIV-1-coinfected female patient and age-matched HIV-1-positive or uninfected women. Patient concerns: A 52-year-old woman diagnosed with SARS-CoV-2/HIV-1 coinfection, ten HIV-1-positive women and five age-matched-healthy individuals were enrolled in this study. Diagnoses: SARS-CoV-2 infection caused severe pneumonia in the second week of illness in HIV-1-positive patient under protease inhibitors. Chest high-resolution computed tomography images of the SARS-CoV-2/HIV-1-coinfected patient showed bilateral ground-glass opacities. Interventions: SARS-CoV-2/HIV-1-coinfected female patient under darunavir/cobicistat regimen received a 7-days hydroxychloroquine therapy. Analysis of IFN α /β mRNA levels and CD4 and CD8 T cell (CD38, human leukocyte antigen-DR [HLA-DR], CD38 HLA-DR) frequencies were performed by RT/real-time PCR assays and flow cytometry, respectively. Median relative difference (MRD) was calculated for each immunological variable. For values greater than reference, MRD should be a positive number and for values that are smaller, MRD should be negative. Outcomes: The severe pneumonia observed in SARS-CoV-2/HIV-1-positive patient under protease inhibitors was reversed by a 7-days hydroxychloroquine therapy. At the end of treatment, on day 7, patient reported resolution of fever, normalization of respiratory rate (14 breaths/min), and improved oxygen arterial pressure with a F i O 2 of 30%. MRD values for IFN α /β and CD4 and CD8 T cells expressing CD38 and/or HLA-DR found in SARS-CoV-2-/HIV-1-coinfected woman were approximatively equal to 0 when refereed respectively to HIV-1-positive female patients [MRDs IFN α/ β: median −0.2545 (range: −0.5/0.1); T cells: median −0.11 (range: −0.8/1.3)] and ≥ 6 when referred to healthy individuals [MRDs IFN α/ β: median 28.45 (range: 15/41.9); T cells: median 10 (range 6/22)]. Lessons: These results indicate that SARS-CoV-2 infection in HIV-1-positive female patient was associated with increased levels of IFNα/β-mRNAs and T cell activation compared to healthy individuals.
【저자키워드】 interferon, severe acute respiratory syndrome coronavirus-2, Protease inhibitor, T cell activation, human immunodeficiency virus-1, 【초록키워드】 COVID-19, Treatment, coronavirus, SARS-COV-2 infection, oxygen, outcome, CD4, protease inhibitors, flow cytometry, Computed tomography, Ground-glass opacities, Fever, female, Patient, IFN, women, severe pneumonia, Human immunodeficiency virus, patients, HLA-DR, CD38, T cell response, Coronavirus-2, Frequency, CD8 T cell, High-resolution, respiratory rate, Type I IFN, immune dysregulation, regimen, leukocyte, acute respiratory syndrome, healthy individuals, individual, PCR assay, hydroxychloroquine therapy, positive, mRNA level, uninfected, FIVE, immunological, IFN α, greater, enrolled, described, performed, caused, diagnosed, median, calculated, expressing, reversed, healthy individual, female patient, infected with SARS-CoV-2, patient reported, 【제목키워드】 Case report, Type I IFN,