Post by Nadica (She/Her) on Nov 3, 2024 2:10:02 GMT
HIV/AIDS and Long COVID are Very Similar - Published Nov 1, 2024
HIV/AIDS & COVID-19, particularly long COVID, share several significant similarities, especially in terms of viral persistence, T cell damage, immune system dysfunction, & activation of other pathogens. These parallels are important for understanding the long-term effects of both infections and their impact on the immune system.
1. Viral Persistence
Both HIV & SARS-CoV-2 can persist in the body, leading to chronic symptoms & immune system complications. In HIV, the virus establishes reservoirs in various tissues, allowing it to evade immune detection and antiretroviral therapy (ART), leading to lifelong infection. Similarly, recent studies at Brigham and Women’s Hospital suggest that a subset of people with long COVID may harbor persistent SARS-CoV-2 proteins in their blood, potentially explaining ongoing symptoms months after the acute infection has resolved[4][10]. This viral persistence is thought to drive chronic inflammation and immune dysfunction in both.
In long COVID, viral reservoirs have been identified in multiple organs, including the gut, blood, & nervous system[12]. This mirrors HIV's ability to persist in tissue reservoirs such as lymphoid tissues. For both viruses, this persistence can lead to prolonged immune activation & may contribute to ongoing symptoms like fatigue, cognitive issues, & cardiovascular problems.
2. T Cell Damage & Exhaustion
Both HIV and SARS-CoV-2 cause significant damage to T cells, particularly CD4+ T cells. In HIV infection, CD4+ T cells are directly targeted by the virus, leading to their depletion over time and resulting in severe immunodeficiency if untreated. Similarly, severe COVID-19 has been associated with a reduction in CD4+ T cells due to excessive immune activation and exhaustion[1][2]. In both, CD8+ T cells also become dysfunctional due to chronic exposure to viral antigens.
T cell exhaustion is a common feature in both infections. In HIV, chronic infection leads to high levels of inhibitory receptors like PD-1 on T cells, contributing to their reduced functionality[2]. In severe COVID-19 cases, similar markers of T cell exhaustion (e.g., PD-1 and TIM-3) are observed[1]. This exhaustion impairs the body's ability to clear the virus effectively and contributes to prolonged illness.
3. Immune System Dysfunction
Both HIV/AIDS & long COVID can lead to profound immune system dysfunction. In HIV infection, even with effective ART, individuals often experience chronic immune activation and systemic inflammation due to incomplete immune recovery[6][9]. This persistent immune activation is linked to increased susceptibility to other infections and long-term health complications.
Similarly, long COVID is believed to involve ongoing immune dysregulation even after the acute phase of SARS-CoV-2 infection has passed. Some studies suggest that persistent viral proteins may continue stimulating the immune system, leading to chronic inflammation[4][12]. This ongoing immune activation may explain why some individuals experience prolonged symptoms such as fatigue, brain fog, or cardiovascular issues even after clearing the virus from most tissues.
4. Activation of Other Pathogens
Both HIV/AIDS and long COVID are associated with the reactivation of latent pathogens due to weakened immune surveillance. In people living with HIV (PLWH), co-infections with viruses like Epstein-Barr virus (EBV) or cytomegalovirus (CMV) are common due to compromised immunity[7]. Similarly, studies have shown that reactivation of latent viruses such as EBV may contribute to long COVID symptoms[7]
In both conditions, the weakened immune system's inability to control these latent infections can exacerbate symptoms and complicate recovery. For example, EBV reactivation has been linked with neurocognitive symptoms in long COVID patients[7], while opportunistic infections such as Pneumocystis jirovecii pneumonia are common in advanced HIV/AIDS patients[3]
So, HIV/AIDS and long COVID share several key similarities regarding viral persistence, T cell damage, immune system dysfunction, and the reactivation of other pathogens. These shared features highlight the importance of understanding how chronic viral infections can lead to long-term health consequences through mechanisms like persistent viral reservoirs and ongoing immune activation. Insights from HIV research may help inform treatment strategies for long COVID, especially in targeting viral persistence with antiviral therapies or addressing chronic immune dysfunction.
Sources
[1] SARS-CoV-2 and HIV-1: So Different yet so Alike. Immune ... pmc.ncbi.nlm.nih.gov/articles/PMC9608044/
[2] Sharing CD4+ T Cell Loss: When COVID-19 and HIV Collide on ... www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2020.596631/full
[3] Overview of SARS-CoV-2 infection in adults living with HIV www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(21)00070-9/fulltext
[4] Study Finds Persistent Infection Could Explain Long COVID in Some ... www.massgeneralbrigham.org/en/about/newsroom/press-releases/study-finds-persistent-infection-could-explain-long-covid-in-some-people
[5] New COVID studies show varied viral clearance time in patients with ... www.cidrap.umn.edu/covid-19/new-covid-studies-show-varied-viral-clearance-time-patients-lower-immunity
[6] Immunologic Interplay Between HIV/AIDS and COVID-19 link.springer.com/article/10.1007/s11904-023-00647-z
[7] Long COVID in people living with HIV - PMC - PubMed Central pmc.ncbi.nlm.nih.gov/articles/PMC10167544/
[8] Persistence and Evolution of SARS-CoV-2 in an ... - NCBI www.ncbi.nlm.nih.gov/pmc/articles/PMC7673303/
[9] The immune response to SARS-CoV-2 in people with HIV - Nature www.nature.com/articles/s41423-023-01087-w
[10] Persistent infection could explain long COVID in some people, study ... www.sciencedaily.com/releases/2024/10/241009122346.htm
[11] Plasma-based antigen persistence in the post-acute phase of ... www.thelancet.com/journals/laninf/article/PIIS1473-3099(24)00211-1/fulltext
[12] Long Covid trials aim to clear lingering virus—and help patients in ... www.science.org/content/article/long-covid-trials-aim-clear-lingering-virus-help-patients-need
HIV/AIDS & COVID-19, particularly long COVID, share several significant similarities, especially in terms of viral persistence, T cell damage, immune system dysfunction, & activation of other pathogens. These parallels are important for understanding the long-term effects of both infections and their impact on the immune system.
1. Viral Persistence
Both HIV & SARS-CoV-2 can persist in the body, leading to chronic symptoms & immune system complications. In HIV, the virus establishes reservoirs in various tissues, allowing it to evade immune detection and antiretroviral therapy (ART), leading to lifelong infection. Similarly, recent studies at Brigham and Women’s Hospital suggest that a subset of people with long COVID may harbor persistent SARS-CoV-2 proteins in their blood, potentially explaining ongoing symptoms months after the acute infection has resolved[4][10]. This viral persistence is thought to drive chronic inflammation and immune dysfunction in both.
In long COVID, viral reservoirs have been identified in multiple organs, including the gut, blood, & nervous system[12]. This mirrors HIV's ability to persist in tissue reservoirs such as lymphoid tissues. For both viruses, this persistence can lead to prolonged immune activation & may contribute to ongoing symptoms like fatigue, cognitive issues, & cardiovascular problems.
2. T Cell Damage & Exhaustion
Both HIV and SARS-CoV-2 cause significant damage to T cells, particularly CD4+ T cells. In HIV infection, CD4+ T cells are directly targeted by the virus, leading to their depletion over time and resulting in severe immunodeficiency if untreated. Similarly, severe COVID-19 has been associated with a reduction in CD4+ T cells due to excessive immune activation and exhaustion[1][2]. In both, CD8+ T cells also become dysfunctional due to chronic exposure to viral antigens.
T cell exhaustion is a common feature in both infections. In HIV, chronic infection leads to high levels of inhibitory receptors like PD-1 on T cells, contributing to their reduced functionality[2]. In severe COVID-19 cases, similar markers of T cell exhaustion (e.g., PD-1 and TIM-3) are observed[1]. This exhaustion impairs the body's ability to clear the virus effectively and contributes to prolonged illness.
3. Immune System Dysfunction
Both HIV/AIDS & long COVID can lead to profound immune system dysfunction. In HIV infection, even with effective ART, individuals often experience chronic immune activation and systemic inflammation due to incomplete immune recovery[6][9]. This persistent immune activation is linked to increased susceptibility to other infections and long-term health complications.
Similarly, long COVID is believed to involve ongoing immune dysregulation even after the acute phase of SARS-CoV-2 infection has passed. Some studies suggest that persistent viral proteins may continue stimulating the immune system, leading to chronic inflammation[4][12]. This ongoing immune activation may explain why some individuals experience prolonged symptoms such as fatigue, brain fog, or cardiovascular issues even after clearing the virus from most tissues.
4. Activation of Other Pathogens
Both HIV/AIDS and long COVID are associated with the reactivation of latent pathogens due to weakened immune surveillance. In people living with HIV (PLWH), co-infections with viruses like Epstein-Barr virus (EBV) or cytomegalovirus (CMV) are common due to compromised immunity[7]. Similarly, studies have shown that reactivation of latent viruses such as EBV may contribute to long COVID symptoms[7]
In both conditions, the weakened immune system's inability to control these latent infections can exacerbate symptoms and complicate recovery. For example, EBV reactivation has been linked with neurocognitive symptoms in long COVID patients[7], while opportunistic infections such as Pneumocystis jirovecii pneumonia are common in advanced HIV/AIDS patients[3]
So, HIV/AIDS and long COVID share several key similarities regarding viral persistence, T cell damage, immune system dysfunction, and the reactivation of other pathogens. These shared features highlight the importance of understanding how chronic viral infections can lead to long-term health consequences through mechanisms like persistent viral reservoirs and ongoing immune activation. Insights from HIV research may help inform treatment strategies for long COVID, especially in targeting viral persistence with antiviral therapies or addressing chronic immune dysfunction.
Sources
[1] SARS-CoV-2 and HIV-1: So Different yet so Alike. Immune ... pmc.ncbi.nlm.nih.gov/articles/PMC9608044/
[2] Sharing CD4+ T Cell Loss: When COVID-19 and HIV Collide on ... www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2020.596631/full
[3] Overview of SARS-CoV-2 infection in adults living with HIV www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(21)00070-9/fulltext
[4] Study Finds Persistent Infection Could Explain Long COVID in Some ... www.massgeneralbrigham.org/en/about/newsroom/press-releases/study-finds-persistent-infection-could-explain-long-covid-in-some-people
[5] New COVID studies show varied viral clearance time in patients with ... www.cidrap.umn.edu/covid-19/new-covid-studies-show-varied-viral-clearance-time-patients-lower-immunity
[6] Immunologic Interplay Between HIV/AIDS and COVID-19 link.springer.com/article/10.1007/s11904-023-00647-z
[7] Long COVID in people living with HIV - PMC - PubMed Central pmc.ncbi.nlm.nih.gov/articles/PMC10167544/
[8] Persistence and Evolution of SARS-CoV-2 in an ... - NCBI www.ncbi.nlm.nih.gov/pmc/articles/PMC7673303/
[9] The immune response to SARS-CoV-2 in people with HIV - Nature www.nature.com/articles/s41423-023-01087-w
[10] Persistent infection could explain long COVID in some people, study ... www.sciencedaily.com/releases/2024/10/241009122346.htm
[11] Plasma-based antigen persistence in the post-acute phase of ... www.thelancet.com/journals/laninf/article/PIIS1473-3099(24)00211-1/fulltext
[12] Long Covid trials aim to clear lingering virus—and help patients in ... www.science.org/content/article/long-covid-trials-aim-clear-lingering-virus-help-patients-need