The case report was published last week in the form of a preprint on the medical preprint website medRxiv. It is worth noting that this report has not yet been peer reviewed.
Image source: https://doi.org/10.1101/2021.06.03.21258228
This study describes a case of a patient who had advanced HIV and failed antiretroviral therapy with persistent SARS-CoV-2 infection and accelerated internal host evolution. Although the clinical condition was short, the PCR positive of SARS-CoV-2 lasted for 216 days.
During the infection process, the E484K mutation of the spike RBD (receptor binding domain) appeared very early. This mutation is related to resistance to class 2 neutralizing antibodies (NAbs). In other cases of persistent infection, E484K was also observed, but in these cases it appeared in the later stages of the infection process. On the 34th day, the Y144 deletion appeared and continued until the 106th day. This is a repetitive deletion region (RDR) in NTD (N-terminal domain) that is related to NAb escape. The deletion of this specific region often occurs in persistent infections.
And as the infection continued, the virus population changed significantly. The E484K mutation was replaced by mutations in other sites related to NAb resistance of 1, 2, and 3 in RBD (K417T and F490S on day 71, 106 The days are L455F and F456L). This mutation pattern is evident in the RBD mutations of E484, K417 and N501, which are the three landmark mutations of the interesting 501Y.V2 (B.1.351) variant.
Phylogenetic analysis of seven SARS-CoV-2 genome sequences in advanced HIV patients
The researchers said that it is not yet clear whether this patient has transmitted these mutated viruses to other people. Although there is no evidence that HIV-infected people are more likely to be infected with the new coronavirus and have serious medical consequences.
Researchers call for the expansion of new coronavirus testing and treatment for undetected HIV carriers, because this “will reduce the death rate of HIV, reduce the spread of HIV, and will also reduce the occurrence of new coronaviruses that may lead to a new wave of epidemics.” The opportunity to mutate the new coronavirus.
So does this mean that a big trouble may come at any time?
According to the “Global AIDS Prevention and Control Progress Report 2020” released by the UNAIDS, there will be approximately 1.7 million new infections in 2019, which is more than three times the global target value. The world‘s efforts to prevent new HIV infections are far behind set objectives.
The report also pointed out that 690,000 people died of AIDS-related diseases in 2019. Of the 38 million people living with HIV, 12.6 million still have no access to life-saving treatment.
In addition, a report recently released by UNICEF shows that in 2019, nearly 320,000 children and adolescents were infected with HIV and 110,000 children and adolescents died of AIDS. About every 100 seconds, a child under the age of 20 is infected with HIV.
In India, where the epidemic is severe, analysts believe that the situation may be as severe as South Africa. If further research shows that there is a close link between the mutation and the spread of the Covid-19 virus among HIV patients, it will be a concern in India, as nearly 1 million people in India are infected with untreated HIV. So far, only 12% of Indians have received the first shot of COVID-19 vaccine, and 3.2% have been fully vaccinated.
According to the data, the earliest recorded cases of HIV patients infected with the new crown came from the United States. As an infectious disease expert at Brigham and Women’s Hospital in Boston, Li was one of the first to record the spread of a significant coronavirus mutation in an immunocompromised patient who was unable to clear the coronavirus infection for more than five months, and finally last summer Died from COVID-19. His case made doctors notice that these patients may be powerful incubators for virus variants. (Bioon Bioon)
This article is comprehensively organized to: Global Times, Beijing New Vision Network, Brokerage China
Reference material: https://doi.org/10.1101/2021.06.03.21258228
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