Journal Article

Effects of tuberculosis and/or HIV-1 infection on COVID-19 presentation and immune response in Africa

Tiffin, Nicki, Wasserman, Sean, Wilkinson, Robert J., Abrahams, Fatima, Goliath, Rene T., Schafer, Georgia, Cerrone, Maddalena, du Bruyn, Elsa, Stek, Cari, Allwood, Brian W., de Vries, Jantina, Jackson, Amanda, Davis, Angharad G., Daroowala, Remi, Coussens, Anna K., Lai, Rachel P.-J., Riou, Catherine, Hsiao, Marvin, Wilkinson, Katalin A., Said-Hartley, Qonita, Ntusi, Ntobeko A. B.

2023

نظرة عامة

Few studies from Africa have described the clinical impact of co-infections on SARS-CoV-2 infection. Here, we investigate the presentation and outcome of SARS-CoV-2 infection in an African setting of high HIV-1 and tuberculosis prevalence by an observational case cohort of SARS-CoV-2 patients. A comparator group of non SARS-CoV-2 participants is included. The study includes 104 adults with SARS-CoV-2 infection of whom 29.8% are HIV-1 co-infected. Two or more co-morbidities are present in 57.7% of participants, including HIV-1 (30%) and active tuberculosis (14%). Amongst patients dually infected by tuberculosis and SARS-CoV-2, clinical features can be typical of either SARS-CoV-2 or tuberculosis: lymphopenia is exacerbated, and some markers of inflammation (D-dimer and ferritin) are further elevated ( p  < 0.05). Amongst HIV-1 co-infected participants those with low CD4 percentage strata exhibit reduced total, but not neutralising, anti-SARS-CoV-2 antibodies. SARS-CoV-2 specific CD8 T cell responses are present in 35.8% participants overall but undetectable in combined HIV-1 and tuberculosis. Death occurred in 30/104 (29%) of all COVID-19 patients and in 6/15 (40%) of patients with coincident SARS-CoV-2 and tuberculosis. This shows that in a high incidence setting, tuberculosis is a common co-morbidity in patients admitted to hospital with COVID-19. The immune response to SARS-CoV-2 is adversely affected by co-existent HIV-1 and tuberculosis. Here the authors describe outcomes of SARS-CoV-2 infection in an African setting of high HIV-1 and tuberculosis prevalence. They find that tuberculosis is a common co-morbidity in patients admitted to hospital with COVID-19 and that the immune response to SARS-CoV-2 is adversely affected by co-existent HIV-1 and tuberculosis.

• الناشر: Nature Publishing Group UK,Nature Publishing Group,Nature Portfolio
• موضوع: 13 / 13/1 / 13/21 / 13/31 / 59 / 692/308 / 692/420 / Adult / Africa - epidemiology / Antibodies / CD4 antigen / CD8 antigen / Coronaviruses / COVID-19 / COVID-19 - complications / COVID-19 - epidemiology / COVID-19 - immunology / Ferritin / HIV / HIV Infections - complications / HIV Infections - epidemiology / HIV-1 / Human immunodeficiency virus / Humanities and Social Sciences / Humans / Immune response / Immune system / Immunity / Infections / Lymphocytes / Lymphocytes T / Lymphopenia / Morbidity / multidisciplinary / Patients / SARS-CoV-2 / Science / Science (multidisciplinary) / Severe acute respiratory syndrome coronavirus 2 / Tuberculosis / Tuberculosis - complications / Tuberculosis - epidemiology