Unsuppressed HIV infection impairs T cell responses to SARS-CoV-2 infection and abrogates T cell cross-recognition

People Living With HIV (PLWH) are at risk of acquiring additional diseases due to the impairment of the body’s natural defense system during HIV infection. This is worsened in cases where HIV infection is out of control, such as before starting ART treatment; when ART treatment is interrupted; or in rare situations where an ART regimen stops working. During the Covid pandemic, individuals experiencing uncontrolled HIV infection were at higher risk of severe Covid disease. To understand why this is, our study compared how the T cells of the body’s immune system reacted to SARS-CoV2 infection in generally healthy people, people living with controlled HIV, and people living with uncontrolled HIV. We found that T cells of people living with uncontrolled HIV were significantly impaired in capacity to react to SARS-CoV2 infection, which would leave this population more vulnerable to Covid disease. Instead, people living with controlled HIV infection, as result of successful ART treatment could respond to SARS-CoV2 infection as efficiently as people without HIV. This emphasizes how important ART treatment is in protecting PLWH from other infections and future pandemics. People experiencing uncontrolled HIV infection should be prioritized for life-saving interventions during future pandemics. Further, gaps in delivering consistent, continuous ART access to all PLWH need to be addressed.