SARS-CoV-2 and HIV co-infection; clinical features, diagnosis, and treatment strategies: A systematic review and meta-analysis

The Effect of SARS-CoV-2 Vaccination on HIV Viral Load in Patients Under Bictegravir/Tenofovir Alafenamide/Emtricitabine Therapy: A Retrospective Observational Study

Background: The aim of our study is to evaluate the impact of SARS-CoV-2 vaccination on HIV viremia in patients treated under bictegravir-based therapy. Methods: We conducted a retrospective observational study in a tertiary hospital, analyzing data from 152 patients treated with BIC/TAF/FTC between 2020 and 2022. Patients were divided into two groups: "vaccinated" (110/152) and "unvaccinated" (42/152) against SARS-CoV-2. The outcomes considered were the presence of "blips" (detectable viremia ≥ 20 copies/mL), "rebound" (viremia ≥ 50 copies/mL), and virological failures. Results: A lower incidence of blips in the "vaccinated" group compared to the "unvaccinated" group (9.1% vs. 28.6%, p = 0.002), and a reduced risk of blips in the vaccinated group (OR 3.8, 95% CI 1.4-9.8) were noticed. The rebound rate was lower in the vaccinated group compared to non-vaccinated, with a statistically significant difference (respectively, 2.7% vs. 11.9%, p = 0.037). Conclusions: our data suggest that SARS-CoV-2 vaccination may stimulate an immune response that enhances CD4+ and CD8+ cell function, contributing to a reduction in the number of blips and maintaining good viro-immunological control in patients with HIV, supporting the importance of vaccination in this population.

Comparative Analysis of Virology and Pathogenesis of SARS-CoV-2 and HIV Infections: Implications for Public Health and Treatment Strategies

Introduction

Coronavirus Disease 19 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), and Human Immunodeficiency Virus (HIV) are significant 21st-century pandemics with distinct virological and clinical characteristics. COVID-19 primarily presents as an acute respiratory illness, while HIV leads to chronic immune suppression. Understanding their differences can enhance public health strategies and treatment approaches.

Purpose

This narrative review compares the virology, transmission, immune responses, and clinical outcomes of SARS-CoV-2 and HIV to inform treatment strategies and public health interventions.

Methods

A narrative review was conducted, synthesizing data from peer-reviewed literature and expert commentary from 2010 to 2024. Databases such as PubMed, Cochrane Library, and Google Scholar were searched for relevant studies.

Results

SARS-CoV-2 primarily spreads through airborne droplets and contaminated surfaces, while HIV transmits through direct contact with infected bodily fluids. The immune response to SARS-CoV-2 involves both innate and adaptive systems, potentially leading to a cytokine storm in severe cases. In contrast, HIV evades the immune system by integrating into host cells, resulting in chronic infection and progressive immune deterioration. Treatment for SARS-CoV-2 focuses on symptom management and prevention, with antiviral medications and vaccines playing crucial roles. Conversely, HIV treatment relies on antiretroviral therapy (ART) to suppress viral replication and maintain immune function.

Conclusion

The review highlights the acute nature of SARS-CoV-2 versus the chronic progression of HIV. Tailored prevention and treatment strategies are essential for effective disease management.

Recommendations

Public health strategies should address the unique transmission routes and progression of both viruses. Further research into vaccine development and therapeutic interventions is critical for improving disease management.

Prevalence, risk factors and the impact of tenofovir treatment in SARS-CoV-2 infection and COVID-19 disease among people living with HIV: A cross-sectional population-based study

OBJECTIVES

The prevalence and risk factors of SARS-CoV-2 infection among unvaccinated people living with HIV (PWH) are not well understood, and the protective role of tenofovir remains controversial. This study aimed to assess the SARS-CoV-2 prevalence and associated risk factors among unvaccinated PWH, and to evaluate the impact of tenofovir.

METHODS

We conducted as a cross-sectional study between November 2020 and May 2021. Plasma samples from 4,400 of 5,476 PWH were tested for total antibodies, IgG, IgM, and IgA.

RESULTS

Among the participants (median age 48 years, 84% male), 92% had undetectable HIV viral loads and 5% had syphilis. The prevalence of SARS-CoV-2 infection was 18% (95% CI 17-19), with 1,180 individuals showing antibodies (IgG 13%, IgA 10%, IgM 11%). Of those seropositive for SARS-CoV-2, 67.5% were asymptomatic, 29% had mild disease, and 3.5% had severe/critical conditions. Risk factors included younger age, being female, men who have sex with men (MSM) status, non-European origin, and a history of syphilis. Neither antiretrovirals nor tenofovir provided protection against SARS-CoV-2 infection or COVID-19 disease.

CONCLUSION

Ongoing surveillance and tailored interventions are crucial for at-risk PWH amid evolving SARS-CoV-2 variants. Tenofovir did not prevent SARS-CoV-2 infection or COVID-19.

COVID-19 and the potential of Janus family kinase (JAK) pathway inhibition: A novel treatment strategy

Recent evidence proposed that the severity of the coronavirus disease 2019 (COVID-19) in patients is a consequence of cytokine storm, characterized by increased IL-1β, IL-6, IL-18, TNF-α, and IFN-γ. Hence, managing the cytokine storm by drugs has been suggested for the treatment of patients with severe COVID-19. Several of the proinflammatory cytokines involved in the pathogenesis of COVID-19 infection recruit a distinct intracellular signaling pathway mediated by JAKs. Consequently, JAK inhibitors, including baricitinib, pacritinib, ruxolitinib, and tofacitinib, may represent an effective therapeutic strategy for controlling the JAK to treat COVID-19. This study indicates the mechanism of cytokine storm and JAK/STAT pathway in COVID-19 as well as the medications used for JAK/STAT inhibitors.

SARS-CoV-2 and HIV: Impact on Pulmonary Epithelial Cells

The SARS-CoV-2 pandemic provides a natural opportunity for the collision of coronavirus disease-2019 (COVID-19) with chronic infections, which place numerous individuals at high risk of severe COVID-19. Infection with Human Immunodeficiency Virus (HIV), a global epidemic, remains a major public health concern. Whether prior HIV+ status exacerbates COVID-19 warrants investigation. Herein, we characterized the impact of SARS-CoV-2 in human bronchial epithelial cells (HBECs) previously exposed to HIV. We optimized the air-liquid interface (ALI) cell culture technique to allow for challenges with HIV at the basolateral cell surface and SARS-CoV-2 spike protein on the apical surface, followed by genetic analyses for cellular stress/toxicity and innate/adaptive immune responses. Our results suggest that the IL-10 pathway was consistently activated in HBECs treated with spike, HIV, or a combination. Recombinant spike protein elicited COVID-19 cytokine storms while HIV activated different signaling pathways. HIV-treated HBECs could no longer activate NF-kB, pro-inflammatory TRAF-6 ubiquitination nor RIP1 signaling. Combinations of HIV and SARS-CoV-2 spike increased gene expression for activation of endoplasmic reticulum-phagosome pathway and downregulated non-canonical NF-kB pathways that are key in functional regulatory T cells and RNA Polymerase II transcription. Our in vitro studies suggest that prior HIV infection may not exacerbate COVID-19. Further in vivo studies are warranted to advance this field.