Although Covid-19 challenges the global health care system, its impact on people with previous diseases such as HIV has attracted special attention. People with HIV are often at risk for various infections, raising key questions about their resilience to SARS-COV-2. This concern stems from the complex interaction between its damaged immune system and the inherently aggressive nature of COVID-19, especially in unvaccinated individuals, which makes the exploration of the intersection a public health priority .
As the world copes with ongoing challenges of the COVID-19 pandemic, recently published in Magazine IscienceLeaded by Professor Giulia Marchetti of the University of Milan, explores the risk of worsening for 19-year-olds who signed with HIV (PLWH) patients (PLWH). This study found how SARS-COV-2 RNAEMIA, skewed T-cell responses and inflammation can amplify the severity of Covid-19 in this vulnerable population.
Professor Marchetti explained the severity of immune dysfunction: “PLWH exhibits significantly higher RNAEMIA than HIV-negative individuals, indicating greater replication of the virus in PLWH and potentially systemic transmission.” She added: “We are based on Analysis of the main components of plasma cytokines found a significant separation between PLWH and HIV-negative individuals, suggesting that the inflammatory response to SARS-COV-2 in PLWH has been intensified. “These insights provide the face of PLWH during COVID-19 A deeper understanding of the unique challenges.
The study adopted a cross-sectional design and recruited uninoculated PLWH and age/gender-matched HIV-negative individuals. Methods such as flow cytometry, ELISA and cytometer arrays were used to analyze SARS-COV-2-specific T cell and humoral responses as well as a set of plasma cytokines. This approach provides a detailed view of how the uninoculated immune system responds to SARS-COV-2 infections uniquely.
Despite relatively retained humoral immunity, PLWH exhibited fewer and fewer multifunctional SARS-COV-2-specific T cells, indicating impaired adaptive immune response to the virus. Special cytokine characteristics in PLWH are elevated levels of granulocyte macrophage stimulating factor (GM-CSF) (GM-CSF), interleukin-4 (IL-4) and tumor necrosis factor-Alpha (TNF-α). Its levels are reduced, and the contents are reduced by interleukin 2 (IL-2) and IL-9. These findings suggest that more severe cytokine storms in PLWH are associated with more severe respiratory deficiency.
To further the importance of this study, the broader impact on public health policy and clinical practice must be considered. These findings underscore the need for proactive health measures tailored specifically for PLWH under pandemic conditions. This includes not only the development of more effective therapeutic interventions, but also enhanced screening and prevention strategies to manage potential outbreaks. Ensuring that these people are vaccinated in a timely manner and are closely monitored for 199 symptoms can significantly reduce hospitalization rates and improve prognosis. Combining these preventive measures with existing HIV care programs can have dual benefits, thereby enhancing the health infrastructure needed to protect these high-risk populations during ongoing and future health crises.
As Professor Giulia Marchetti and his team stressed, these profound effects highlight the urgent need for tailored strategies for the effective management of SARS-COV-2 infection in PLWH. Professor Marchetti shows that enhanced surveillance and possible early treatment strategies are critical to mitigating the severe impact observed in this vulnerable population.
Journal Reference
Augello, Matteo; Bono, Valeria; Roberta rovito; et al. “Association between SARS-COV-2 RNAEMIA, skewed T-cell response, inflammation and severity of HIV-infected individuals.” IscienceJanuary 19, 2024. DOI: https://doi.org/10.1016/j.isci.2023.108673
About the Author
Giulia Marchetti She received her PhD in 1995, completed her residency for infectious diseases in 2000 (Milan), and received her PhD in HIV/AIDS in 2003 (Milan).
She visited researchers at RIVM (Bilsowen, Netherlands), Rush University (Chicago, USA) and NIH (Bethesda, USA) between 1996 and 2002. St. Paul’s Hospital runs a laboratory focused on studying the pathogenesis and immune structure of HIV, and recently SARS-COV-2-related diseases.
She is now the head of the infectious disease clinic of the Sao Paulo hospital in Milan.
Dr. Marchetti has been involved in the study of HIV pathogenesis, therapies, and HIV-related comorbidities since 1996, and has authored or co-authored more than 180 original peer-reviewed publications in the field. In particular, her main research area is the occurrence of immune morbidity of HIV infection, with particular attention to the interconnection between HIV-related inflammation and gastrointestinal system damage. Recently, she began a new research topic on the occurrence of immune morbidity of Covid-19, focusing specifically on the pathogenic determinants of severe and mild diseases. She is a PI of several competitive grants from the Italian Ministry of Health, Lombardy Region, Fondazione Cariplo, Horizon Horizon for studying the generation of immunomorbidity in HIV and, more recently, SARS-COV-2.
Her work has been introduced at national and international conferences and has attended and invited lecturers from national and international conferences.
Matteo AugelloMD, is an infectious disease and tropical medicine specialist in the infectious disease and tropical medicine clinic of San Paolo Hospital in Milan, Italy. He currently has a Ph.D. Student of the Department of Health Sciences, University of Milan. His main interest is in the immune response to viral infections (mainly HIV) and vaccines. During the Covid-19 pandemic, he has been involved in projects aimed at characterizing the immune response of HIV patients to natural infection and vaccination of SARS-COV-2.
I am Roberta RovitoPostdoctoral fellow Professor Giulia Marchetti of the University of Milan, Infectious Diseases Clinic in St. Paul’s Hospital.
My educational and professional background is influenced by understanding pathogen bypass host defense and host adoption strategies to cope with the dynamics of infection. It turns out that one aspect of the final years of the Covid-19-19 pandemic is crucial.
So, after my master’s degree in Molecular Virology at the University of Turin, especially in my master’s degree in medical biotechnology, I had the opportunity to pursue my PhD in the European Marie Curie framework aimed at training the next generation of vaccine scientists. I have received my PhD from the Department of Medical Microbiology, Leiden University Medical Center, Netherlands, working on the role of immune diseases in congenital cytomegalovirus infection.
After my PhD, I started my postdoctoral degree at Professor Giulia Marchetti at the University of Milan, the infectious disease clinic at San Paolo Hospital. My work focuses on immune attacks from SARS-COV-2 and HIV infections.
Camilla TincatiMD, PhD. I specialize in infectious diseases with expertise in HIV infection management. My medical background has led me to explore the causes of HIV-induced multiple immune abnormalities that are related to clinical progression (non-infectious comorbidities) in patients with HIV (PLWH).
My current research focuses on the role of the gastrointestinal tract in the pathogenesis of HIV infection. My observation is that altered mucosal structure, immunity, and microbiome are key to explaining disease progression, and I have also studied their interactions in HPV-related dysplasia and cancer.
Valeria BonoM.SC is a doctoral candidate for the translational medicine program at the University of Milan. She has been studying antigen-specific T-cell and humoral responses in HIV-infected people with SARS-COV-2 infection. Currently, her focus is on the study of inflammation, microbial translocation and intestinal barrier damage in primary and chronic HIV infections.
