COVID-19: Prolonged viral shedding in an HIV patient

Description

Objectives.
COVID-19 is novel infectious disease with an evolving understanding of its epidemiology and clinical manifestations. Immunocompromised patients often present atypical presentations of viral infected diseases. The aim of the study was to show laboratory results for a case simultaneously infected by HIV and SARS-Cov-2 virus with prolonged viral shedding.
Materials and methods.
Nasopharyngeal swabs to detect SARS-CoV-2 RNA by real time polymerase chain reaction (RT PCR) and Next Generation Sequencing (NGS) to detect variant, serum to detect IgA, IgM, IgG antibodies by ELISA, nasopharyngeal swab to detect SARS-CoV-2 virus by VeroSlam cell culture.
Results.
27-year-old woman was hospitalized in the hospital of Infectology Centre of Latvia in July with COVID-19 infection. During the hospitalization was confirmed HIV with 8 CD4 cells/µl. The first positive RT PCR SARS-CoV-2 RNA test was done on 1st June. Also in July, August (three times) results were positive by RT PCR. The last positive RT PCR test was on 30 September, all nasopharyngeal swabs results were “Detected SARS-CoV-2 RNA (E, RdRP/S, N genes)”, Ct values were between 15 and 26. Five positive nasopharyngeal swabs by RT PCR was sequenced by NGS with detected B1.17 (alfa) variant. IgA, IgM and IgG antibodies weren’t developed. NRL firstly performed cell culture for SARS-CoV-2 virus and checked it by RT PCR.
Conclusions.
We present a unique case of significantly prolonged viral shedding (122 days) in a HIV positive patient with acquired immunodeficiency syndrome (AIDS) without antibodies development against SARS-CoV-2 virus. Cell culture allowed to understand that it was prolonged viral shedding and by NGS that it wasn’t reinfection by another SARS-CoV-2 virus variant.

Period	24 Sept 2022
Event title	XVI Baltic Congress in Laboratory Medicine
Event type	Congress
Conference number	16
Location	Tallinn, EstoniaShow on map
Degree of Recognition	International