Effect of HIV status and suppression on SARS-CoV-2 disease severity, vaccine response, and evolution.
| dc.contributor.advisor | Sigal, Alexander. | |
| dc.contributor.advisor | Moosa, Mahomed Yunus Suleman. | |
| dc.contributor.author | Karim, Farina. | |
| dc.date.accessioned | 2023-09-29T10:39:23Z | |
| dc.date.available | 2023-09-29T10:39:23Z | |
| dc.date.created | 2023 | |
| dc.date.issued | 2023 | |
| dc.description | Doctoral Degree. University of KwaZulu-Natal, Durban. | en_US |
| dc.description.abstract | SARS-CoV-2 is a global pandemic that has infected 672,115,430 people globally (https://coronavirus.jhu.edu/map.html, accessed 08.02.2023). SARS-CoV-2 is continuously evolving, and new variants pose a continuous threat to curbing this pandemic. Simultaneously, South Africa still struggles to control and manage an enduring HIV pandemic. The synergistic interplay between these two pandemics has necessitated an understanding of how these two viruses interact with each other to tailor an intervention. This thesis investigated the effect of SARS-CoV-2 infection on disease dynamics, differential disease outcomes, vaccine response, as well as SARSCoV- 2 evolution in people living with HIV (PLWH) with different levels of HIV suppression and differing HIV suppression history. The first study investigated the difference in disease severity amongst PLWH in the first and second infection waves in South Africa. COVID-19. Thereafter, we explored persistent SARS-CoV-2 infection in immunocompromised individuals and intra-host evolution in a case study of a participant with advanced HIV infection. Here, we illustrated that advanced HIV disease may lead to prolonged SARS-CoV-2 infection and shedding of infectious virus and results in intra-host evolution of variant mutations, making intra-host evolution in advanced HIV individuals a particular concern within the South African context. Finally, we observed that effectively controlling HIV through ART facilitates SARS-CoV-2 clearance. The last study widened the observations to five participants with advanced HIV disease and showed that vaccination does induce a potent neutralizing antibody response in this group, but only if HIV viremia is first effectively suppressed with antiretroviral therapy. These findings highlight the importance of suppressing HIV infection in eliciting an effective immune response against, and preventing evolution of SARS-CoV-2. | en_US |
| dc.identifier.uri | https://researchspace.ukzn.ac.za/handle/10413/22329 | |
| dc.language.iso | en | en_US |
| dc.subject.other | Human Immunodeficiency Virus. | en_US |
| dc.subject.other | Severe Acute Respiratory Syndrome Coronavirus-2. | en_US |
| dc.subject.other | Vaccination. | en_US |
| dc.subject.other | CD4. | en_US |
| dc.subject.other | Live virus neutralization assay. | en_US |
| dc.title | Effect of HIV status and suppression on SARS-CoV-2 disease severity, vaccine response, and evolution. | en_US |
| dc.type | Thesis | en_US |