Robust SARS-CoV-2-specific serological and functional t-cell immunity in PLWHIV


BACKGROUND: While description of protective humoral and T-cell immune responses has been reported among immunocompetent (IC) individuals, its characterization among PLWHIV remains uncertain.
METHODS: SARS-CoV-2-specific serological and functional T-cell immune responses against main immunogenic antigens were assessed in 11 HIV-positive patients at three (T1) and six months (T2) following confirmed-SARS-CoV-2-infection, and compared to a cohort of 34 immunocompetent (IC) individuals developing mild (outpatient, n=21) and severe (inpatient, n=13) disease. Also, SARS-CoV-2 (Spike)-specific memory B cells responses were investigated A healthy non-infected group of 16 patients whose PBMC (peripheral blood mononuclear cells) had been bio-banked before COVID-19 pandemic (2018) were also analyzed.
RESULTS: Median (range) age was 51 (33-67); nadir and current T-CD4 cell count was 219 cells/ml (28-600) and 633 cells/ml (284-1000) respectively. Only 5/11 patients needed hospital admission and one of them required ICU. Patients displayed similar IFN-γ, IL2 and polyfunctional IFN-γ/IL2 producing T-cell frequencies than IC with mild symptoms at three and six months after infection. IC patients with more severe COVID-19 infection exhibited the highest T-cell immune responses (Figure 1). However, all (14/14) severe, 7/11 (63%) HIV and 3/18 (16.7%) mild IC patients showed IgG seropositivity at 6 months (p<0.005) (Figure 2). Interestingly, a broad range of SARS-CoV-2 (Spike)-specific memory B-cell responses in the majority of HIV patients, despite the absence of SARS-CoV-2-specific IgG antibodies at three (4/4) and six (2/4) months (Figure 3).

CONCLUSIONS: Our data suggest a comparable natural immunization among chronic HIV, similar to that of IC convalescent patients developing similar COVID-19 disease severity. Notably, functional B and T-cell assessment may more reliably detect immunized patients with robust immune memory responses as compared to serological memory assessment during mid-term convalescence.