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Source: HIV-COVID-19  Jul 10, 2021  2 years, 9 months, 1 week, 20 hours, 25 minutes ago

COVID-19 Warning! Case Studies Show That HIV Patients Contracting COVID-19 Are Ideal Vivo Laboratories For Creating Worrisome SARS-CoV-2 Mutations!

COVID-19 Warning! Case Studies Show That HIV Patients Contracting COVID-19 Are Ideal Vivo Laboratories For Creating Worrisome SARS-CoV-2 Mutations!
Source: HIV-COVID-19  Jul 10, 2021  2 years, 9 months, 1 week, 20 hours, 25 minutes ago
HIV-COVID-19: Numerous case studies are emerging that special attention needs to be paid to HIV patients should they contract the COVID-19 disease as their immunocompromised conditions make them perfect ‘vivo laboratories’ for the SARS-CoV-2 to constantly mutate and develop more potent and worrisome mutations and resultant variants.

In one case study published on a preprint server by researchers from South Africa, a female HV patient in South Africa became a veritable COVID-19 variant laboratory as the virus mutated more than 30 times in 216 days of her infection! https://www.medrxiv.org/content/10.1101/2021.06.03.21258228v1.full
 
Although most individuals effectively clear SARS-CoV-2, there are several reports of prolonged infection in immunosuppressed individuals.
 
In this case report cum study, the researchers presented a case of prolonged infection of greater than 6 months with shedding of high titter SARS-CoV-2 in an individual with advanced HIV and antiretroviral treatment failure.
 
Through whole genome sequencing at multiple time-points, the study team demonstrated the early emergence of the E484K substitution associated with escape from neutralizing antibodies, followed by other escape mutations and the N501Y substitution found in most variants of concern.
 
Alarmingly this provides support to the hypothesis of intra-host evolution as one mechanism for the emergence of SARS-CoV-2 variants with immune evasion properties.
 
Importantly the new properties developed by the SARS-CoV-2 virus during its incubation in this HIV patient’s body enabled it to increase in strength, resist certain vaccine compounds and block some COVID-19 therapeutics.
 
In this case report, altogether there were 13 genetic changes related to the virus’ spike protein and 19 additional genetic changes that further changed its behavior.
 
Some of these changes became persistent, and then declined as other mutations became more prevalent. Consequently, the variant that emerged was better able to evade the body’s immune system.
 
The study team from the University of KwaZulu-Natal in South Africa told Thailand Medical News, “Unlike many of the other reported cases, virus evolution was not driven by the receipt of immune-based therapies (convalescent plasma or monoclonal antibodies).”
 
The team suggests the viral evolution “may have been driven by selective pressure from an impaired neutralizing antibody response.”
 
For instance, the E484K mutation in the spike receptor binding domain emerged very early in the course of the infection ie 19 days after the first onset of symptoms.  Typically, this mutation occurs late in the course of COVID-19. It is associated with resistance to class 2 neutralizing anti