Summary Characterizing SARS-CoV-2 evolution in specific geographies may help predict properties of the variants that come from these regions. We mapped neutralization of a SARS-CoV-2 strain that evolved over 6 months from ancestral virus in a person with advanced HIV disease in South Africa; this person was infected prior to emergence of the Beta and Delta variants. We longitudinally tracked the evolved virus and tested it against self-plasma and convalescent plasma from ancestral, Beta, and Delta infections. Early virus was similar to ancestral, but it evolved a multitude of mutations found in Omicron and other variants. It showed substantial but incomplete Pfizer BNT162b2 escape, weak neutralization by self-plasma, and despite pre-dating Delta, it also showed extensive escape of Delta infection-elicited neutralization. This example is consistent with the notion that SARS-CoV-2 evolving in individual immune-compromised hosts, including those with advanced HIV disease, may gain immune escape of vaccines and enhanced escape of Delta immunity, and this has implications for vaccine breakthrough and reinfections. Graphical abstract Highlights • An ancestral SARS-CoV-2 infection that persisted over 6 months evolved neutralization escape • Evolved virus serological relationship is mapped to ancestral virus and key variants • Evolved virus shows greatest escape from Delta-elicited immunity and least from Beta-elicited immunity • Evolved virus substantially but incompletely escapes BNT162b2 vaccine-elicited antibodies Cele et al. examine a SARS-CoV-2 infection persisting over 6 months, starting as ancestral virus but evolving various mutations found in Omicron and other variants. The evolved virus substantially but incompletely escaped BNT162b2-elicited immunity as well as neutralization by self-plasma and showed extensive escape from neutralization elicited by Delta infections.
【저자키워드】 Evolution, SARS-CoV-2, HIV, neutralization, variants of concern, delta variant, Immune escape, Beta variant, advanced HIV disease, 【초록키워드】 convalescent plasma, Vaccine, Mutation, Immunity, antibody, SARS-COV-2 infection, variant, Delta, omicron, virus, variants, BNT162b2, Pfizer, infections, SARS-CoV-2 evolution, Beta, serological, predict, Abstract, other variants, help, hosts, South, SARS-CoV-2 strain, HIV disease, regions, implication, tested, example, elicited, mapped, escaped, 【제목키워드】 Prolonged infection, HIV disease,