A 36-year-old South-African woman with advanced HIV carried coronavirus for 216 days and accumulated more than 30 mutations, reported a new study on medRxiv.
The case report was published as a preprint on medRxiv, so it has not been peer-reviewed. The woman was kept anonymous.
According to the study, the coronaviruses mutated 13 times in the spike protein, the part known to help the virus escape the immune response, and 19 other mutations occurred that could change the virus’s behavior.
According to the Los Angeles Times, it is unclear if she passed her mutations on to others.
Tulio de Oliveira, a geneticist at the University of KwaZulu-Natal in Durban and the study’s author, told the Times: “If more such cases are found, it raises the prospect that HIV infection could be a source of new variants simply because the patients could carry the virus for longer.”
Dr Juan Ambrosini, associate professor of infectious diseases at the University of Barcelona, commented, “But it is probably the exception rather than the rule for people living for HIV, because prolonged infection requires severe immunocompromise.” In this case, the woman in the case study was immunosuppressed.
Dr Ambrosini continued to say that these findings are important for controlling Covid-19, as the patients could be a continuous source of transmission and evolution of the virus.
Study author, de Oliveira, told the Times that the woman’s case could easily have gone unnoticed, as she only displayed mild symptoms of Covid-19 despite still carrying the virus.
Scientists were able to spot this case because she was enrolled in a study looking at the immune response to Covid-19 with 300 HIV-positive people.
Similarly, the researchers found four others with HIV had carried the virus for longer than a month.
There has only been one other case study published about a person with HIV carrying the virus for a prolonged period of time.
Even patients who are immunosuppressed for other reasons have been seen to carry the virus for prolonged periods of time, Ambrosini shared. For instance, some people with kidney transplants have tested positive for almost a year.
The findings of this case study could be particularly important for Africa, which had 20.6 million out of its 37.6 million people living with HIV in 2020. The World Health Organization warned that a sharp rise in infections could turn into a continent-wide third wave of Covid-19.
