Immune Dysregulation in HIV and COVID-19 Co-infection: Therapeutic Implications

Abstract

Background

Co-infection with HIV and SARS-CoV-2 presents a complex clinical picture. Deciphering the immune response in this population, particularly the role of cytokines underlying immunopathogenesis could elucidates the development of targeted therapeutic interventions.

Methods

This prospective, two-stage study enrolled 75 individuals with HIV diagnosed with COVID-19 (case group) and 25 individuals from the general population infected with SARS-CoV-2 only (control group). COVID-19 diagnosis followed World Health Organization guidelines. Plasma cytokine levels were measured using a cytokine bead array.

Results

The case group skewed slightly females (61.2% vs. 42.9% female in the control group) an average age of 3 years older (44.13 years vs. 40.86 years). Importantly, all the case group participants had mild complications, while a significant majority (88.1%) in the control group experienced severe complications. The control group displayed a substantially higher IgM titer 963 IU/mL compared to only 39.3 IU/mL in the case group. The control group had significantly higher levels of IL-6, IL-10, IFN-γ, TNF-α compared to the case group.

Conclusion

This study suggests a potentially distinct immune response in HIV-positive patients when infected with SARS-CoV-2. Elucidating these differences could lead to the development of more effective treatment strategies for this vulnerable population.