HIV Patient Who Harbored SARS-CoV-2 For Nine Months Developed At Least 21 Mutations of the Virus

A South African woman with an inadequately treated HIV and SARS-CoV-2 for nine months saw the respiratory virus develop into at least 21 mutations. The study that documented her case revealed that the 22-year-old adhered to the antiretroviral medication for weeks when she got infected with COVID-19.

According to the Center for Strategic and International Studies, South Africa has the world's biggest HIV epidemic in which 60% of its women are infected and prevalence to its overall population has exceeded 15%. HIV is known to weaken the immune system and make them more susceptible to illnesses.

SARS-CoV-2 Virus Mutates Easily in Immunocompromised Individuals

Bloomberg reported that the SARS-CoV-2 virus the woman harbors developed at least 10 mutations on the spike protein, which improved its binding properties to cells and 11 other mutations. Scientists said that some of the mutations were commonly seen in the Omicron and Lambda variants of the virus. At the same time, they also observed that some mutations allow the virus to evade antibodies.

Through undergoing the antiretroviral medication, the woman's immune system also strengthened, allowing her to overcome the COVID-19 infection within six to nine weeks. The non-peer-reviewed study is led by scientists from Stellenbosch and the University of KwaZulu-Natal.

Although it is not yet peer-reviewed, the study adds to the growing evidence that COVID-19 may mutate rapidly when inside immunocompromised individuals, such as those HIV patients who are not taking antiretroviral medication, and develop into new variants. Researchers noted that the variant they detected in the South African woman was the Omicron variant.

"This case, like others before, describes a potential pathway for the emergence of novel variants," Bloomberg Quint quoted the scientists who said that it was still a hypothesis. They added that the woman's reaction to the virus also showed that antiretroviral treatment is a key in controlling the virus inside an HIV patient's body.

COVID-19 and HIV in South Africa

A paper in the journal BMJ said that COVID-19 and HIV are two pandemics that must be controlled collectively and globally. A growing consensus showed that the Omicron variant may have evolved during a prolonged infection in immunocompromised individuals. Some scientists also hypothesized that the variants emergence in South Africa may have owed its origin to the HIV pandemic that continues to cause immunodeficiency in the region.

Out of the 60 million population in South Africa, around 8 million are suffering from HIV or about one-fifth of all the HIV-infected people globally. A high number of people diagnosed with the Omicron variant are at an advanced stage of HIV and have already started treatment but are inadequate due to lack of resources, poverty, and stigma.

Both COVID-19 and HIV have left large numbers of immunocompromised people at greater risk of prolonged infections that make them vulnerable to illness and mutated versions of the virus.

The United Nations human rights approach has played an important role in the effectiveness of responses to HIV. It could also be applied to COVID-19 to improve equitable access to healthcare while simultaneously addressing social determinants of health.

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