HIV skews the SARS-CoV-2 B cell response toward an extrafollicular maturation pathway
- Africa Health Research Institute, South Africa
- University of KwaZulu-Natal, South Africa
- International AIDS Vaccine Initiative, United States
- Scripps Research Institute, United States
Abstract
Background: HIV infection dysregulates the B cell compartment, affecting memory B cell formation and the antibody response to infection and vaccination. Understanding the B cell response to SARS-CoV-2 in people living with HIV (PLWH) may explain the increased morbidity, reduced vaccine efficacy, reduced clearance, and intra-host evolution of SARS-CoV-2 observed in some HIV-1 coinfections.
Methods: We compared B cell responses to COVID-19 in PLWH and HIV negative (HIV-ve) patients in a cohort recruited in Durban, South Africa, during the first pandemic wave in July 2020 using detailed flow cytometry phenotyping of longitudinal samples with markers of B cell maturation, homing and regulatory features.
Results: This revealed a coordinated B cell response to COVID-19 that differed significantly between HIV-ve and PLWH. Memory B cells in PLWH displayed evidence of reduced germinal center (GC) activity, homing capacity and class-switching responses, with increased PD-L1 expression, and decreased Tfh frequency. This was mirrored by increased extrafollicular (EF) activity, with dynamic changes in activated double negative (DN2) and activated naïve B cells, which correlated with anti-RBD-titres in these individuals. An elevated SARS-CoV-2 specific EF response in PLWH was confirmed using viral spike and RBD bait proteins.
Conclusions: Despite similar disease severity, these trends were highest in participants with uncontrolled HIV, implicating HIV in driving these changes. EF B cell responses are rapid but give rise to lower affinity antibodies, less durable long-term memory, and reduced capacity to adapt to new variants. Further work is needed to determine the long-term effects of HIV on SARS-CoV-2 immunity, particularly as new variants emerge.
Funding: This work was supported by a grant from the Wellcome Trust to the Africa Health Research Institute (Wellcome Trust Strategic Core Award [grant number 201433/Z/16/Z]). Additional funding was received from the South African Department of Science and Innovation through the National Research Foundation (South African Research Chairs Initiative, [grant number 64809]), and the Victor Daitz Foundation.
Data availability
All data generated or analyzed during this study are included in the manuscript and Source data 1.
Article and author information
Author details
Funding
Wellcome Trust (201433/Z/16/Z)
- Alex Sigal
National Research Foundation (64809)
- Alex Sigal
Victor Daitz Foundation
- Alex Sigal
Max Planck Institute for Infection Biology (open access funding)
- Alex Sigal
The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.
Reviewing Editor
- Bavesh D Kana, University of the Witwatersrand, South Africa
Ethics
Human subjects: The study protocol was approved by the University of KwaZulu-Natal Biomedical Research Ethics Committee (approval BREC/00001275/2020). Written informed consent was obtained for all enrolled participants.
Version history
- Received: May 3, 2022
- Preprint posted: June 15, 2022 (view preprint)
- Accepted: October 23, 2022
- Accepted Manuscript published: October 27, 2022 (version 1)
- Version of Record published: November 8, 2022 (version 2)
Copyright
© 2022, Krause et al.
This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.
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HIV skews the SARS-CoV-2 B cell response toward an extrafollicular maturation pathway
eLife 11:e79924.
https://doi.org/10.7554/eLife.79924
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