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

Article scientifique 2023 Anglais

Résumé

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.

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Bruyn, E., Stek, C., Daroowala, R., Said-Hartley, Q., Hsiao, M., Schäfer, G., Goliath, R., Abrahams, F., Jackson, A., Wasserman, S., Davis, A., Lai, R., Coussens, A., Wilkinson, K., Vries, J., Tiffin, N., Cerrone, M., Ntusi, N., Abrahams, F., Allwood, B., Aziz, S., Bangani, N., Black, J., Blumenthal, M., Bremer, M., Burgers, W., Ciko, Z., Daroowala, R., Esmail, H., Gordon, S., Harley, Y., Lakay, F., Martínez, F., Meintjes, G., Mendelson, M., Papavarnavas, N., Proust, A., Ruzive, S., Serole, K., Whitaker, C., Wilkinson, R., Zvinairo, K., Riou, C. (2023). Effects of tuberculosis and/or HIV-1 infection on COVID-19 presentation and immune response in Africa. https://doi.org/10.1038/s41467-022-35689-1

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Auteur(s)

Elsa Du Bruyn Cari Stek Remi Daroowala Qonita Said-Hartley Marvin Hsiao Georgia Schäfer René Goliath Fatima Abrahams Amanda Jackson Sean Wasserman Angharad Davis Rachel Lai Anna K. Coussens Katalin A. Wilkinson Jantina de Vries Nicki Tiffin Maddalena Cerrone Ntobeko Ntusi Fatimah Abrahams Brian Allwood Saalikha Aziz Nonzwakazi Bangani John Black Melissa J. Blumenthal Marise Bremer Wendy A. Burgers Z Ciko Remy Daroowala Hanif Esmail Siamon Gordon Yolande X. R. Harley Francisco Lakay Fernando O. Martínez Graeme Meintjes Marc Mendelson Nectarios Papavarnavas Alizé Proust Sheena Ruzive Keboile Serole Claire Whitaker Robert J. Wilkinson Kennedy Zvinairo Catherine Riou

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