New amfAR Grants Target Intersection HIV and COVID-19

In January, amfAR awarded approximately $700,000 in funding to researchers aiming to answer two key questions at the intersection of HIV and SARS-CoV-2, the virus that causes COVID-19. First, what are the risks for COVID “long-haulers”—those who continue to experience debilitating symptoms long after clearing infection—who are living with HIV? And second, what, if any, effect does SARS-CoV-2 have on the HIV reservoir?

Since the emergence of the pandemic, researchers have expressed concern regarding COVID outcomes among people living with HIV (PLWH). After an extensive analysis of more than 4,500 coronavirus research papers covering the first six months of the pandemic, an amfAR team led by Vice President and Director of Research, Dr. Rowena Johnston, concluded that PLWH were not at increased risk of either hospitalization or death.

“The effects of COVID-19 on people living with HIV has been a driving concern for us,” said Dr. Johnston. “We look forward to finding answers to the next set of issues concerning longer-term consequences of co-infection and how these may impact future care.”

A recent study in the UK suggests that as many as 10% of people diagnosed with COVID-19 experience symptoms for three months or more after contracting the infection. But little is known about long COVID beyond the fact that common symptoms such as persistent fatigue, muscle weakness, brain fog, sleep difficulties, anxiety and depression can be extremely debilitating.

Annukka Antar, M.D., Ph.D., of Johns Hopkins University, along with Michael Peluso, M.D., of the University of California, San Francisco, will compare this phenomenon across three groups of study participants from across the U.S. PLWH who have survived COVID-19 will be compared to PWH with no history of COVID and survivors who are HIV negative. Using a mobile phlebotomy service, Drs. Antar and Peluso will also collect blood samples and study vital signs to aid in understanding the biological underpinnings of long-term COVID.

Currently there are no data on the effect of coronavirus infection on the nature or size of the HIV reservoir. The strong immune responses associated with infection may impact the size of the HIV reservoir. This depends on how these immune responses affect T cells, the main target of HIV infection, and the effectiveness of antiretroviral therapy at preventing infection of previously uninfected cells.

Mathias Lichterfeld, M.D., Ph.D., of Massachusetts General Hospital, and colleagues plan to assess the size and nature of the reservoir in PLWH before and after coronavirus infection. The researchers will compare the percentage of cells that are HIV-infected with samples stored before the COVID-19 pandemic. They will also look for any effect of the site of HIV integration within the human DNA on reservoir size and assess the likelihood of activation by COVID-associated immune responses. Understanding these changes will help inform future HIV curative interventions.

“We’re greatly relieved to learn that people living with HIV appear to be at no greater risk than anyone else of hospitalization or death as a result of COVID-19,” said amfAR Chief Executive Officer Kevin Robert Frost. “But there are many questions about SARS-CoV-2 and its potential interactions with HIV that remain unanswered, and we hope these research projects will yield important new knowledge about both viruses.”