RT Journal Article T1 SARS-CoV-2 Evolution and Spike-Specific CD4+ T-Cell Response in Persistent COVID-19 with Severe HIV Immune Suppression. A1 Álvarez, Hortensia A1 Ruiz-Mateos, Ezequiel A1 Juiz-González, Pedro Miguel A1 Vitallé, Joana A1 Viéitez, Irene A1 Vázquez-Friol, María Del Carmen A1 Torres-Beceiro, Isabel A1 Pérez-Gómez, Alberto A1 Gallego-García, Pilar A1 Estévez-Gómez, Nuria A1 De Chiara, Loretta A1 Poveda, Eva A1 Posada, David A1 Llibre, Josep M K1 CD4+ T cell response K1 HIV K1 SARS-CoV-2 AB Intra-host evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been reported in cases with persistent coronavirus disease 2019 (COVID-19). In this study, we describe a severely immunosuppressed individual with HIV-1/SARS-CoV-2 coinfection with a long-term course of SARS-CoV-2 infection. A 28-year-old man was diagnosed with HIV-1 infection (CD4+ count: 3 cells/µL nd 563000 HIV-1 RNA copies/mL) and simultaneous Pneumocystis jirovecii pneumonia, disseminated Mycobacterium avium complex infection and SARS-CoV-2 infection. SARS-CoV-2 real-time reverse transcription polymerase chain reaction positivity from nasopharyngeal samples was prolonged for 15 weeks. SARS-CoV-2 was identified as variant Alpha (PANGO lineage B.1.1.7) with mutation S:E484K. Spike-specific T-cell response was similar to HIV-negative controls although enriched in IL-2, and showed disproportionately increased immunological exhaustion marker levels. Despite persistent SARS-CoV-2 infection, adaptive intra-host SARS-CoV-2 evolution, was not identified. Spike-specific T-cell response protected against a severe COVID-19 outcome and the increased immunological exhaustion marker levels might have favoured SARS-CoV-2 persistence. SN 2076-2607 YR 2022 FD 2022-01-11 LK http://hdl.handle.net/10668/21431 UL http://hdl.handle.net/10668/21431 LA en DS RISalud RD Apr 10, 2025