biostudies-literatureKarim FU.S. Department of Health & Human Services | NIH | National Institute of Allergy and Infectious DiseasesNIAID NIH HHSBill and Melinda Gates FoundationWellcome TrustGates Foundation2360https://www.ebi.ac.uk/biostudies/studies/S-EPMC10943233biostudies-literatureUnknown15(1)SARS-CoV-2 clearance requires adaptive immunity but the contribution of neutralizing antibodies and T cells in different immune states is unclear. Here we ask which adaptive immune responses associate with clearance of long-term SARS-CoV-2 infection in HIV-mediated immunosuppression after suppressive antiretroviral therapy (ART) initiation. We assembled a cohort of SARS-CoV-2 infected people in South Africa (n = 994) including participants with advanced HIV disease characterized by immunosuppression due to T cell depletion. Fifty-four percent of participants with advanced HIV disease had prolonged SARS-CoV-2 infection (>1 month). In the five vaccinated participants with advanced HIV disease tested, SARS-CoV-2 clearance associates with emergence of neutralizing antibodies but not SARS-CoV-2Nature communicationsClearance of persistent SARS-CoV-2 associates with increased neutralizing antibodies in advanced HIV disease post-ART initiation.PMC10943233INV-018944R01 AI138546R01AI138546-05226137/Z/22/ZHanekom WReedoy Kde Oliveira TRiou CAbdool Karim SSManickchund NMoore PLMoosa MSUpton JLGovender KMakhado ZSigal Avon Gottberg AMagula NGanga YGosnell BILessells RJBurgers WAKeeton RSThambu KVenter EKarim QAMazibuko Mvan Graan SLustig GKarim FJule ZKhan KNgcobo NBernstein MHoque MfalseClearance of persistent SARS-CoV-2 associates with increased neutralizing antibodies in advanced HIV disease post-ART initiation.SARS-CoV-2 clearance requires adaptive immunity but the contribution of neutralizing antibodies and T cells in different immune states is unclear. Here we ask which adaptive immune responses associate with clearance of long-term SARS-CoV-2 infection in HIV-mediated immunosuppression after suppressive antiretroviral therapy (ART) initiation. We assembled a cohort of SARS-CoV-2 infected people in South Africa (n = 994) including participants with advanced HIV disease characterized by immunosuppression due to T cell depletion. Fifty-four percent of participants with advanced HIV disease had prolonged SARS-CoV-2 infection (>1 month). In the five vaccinated participants with advanced HIV disease tested, SARS-CoV-2 clearance associates with emergence of neutralizing antibodies but not SARS-CoV-22024-01-01T00:00:00Z2024 Mar2026-07-15T08:25:34.124Z2024-11-07T11:27:24.633ZS-EPMC109432333849105010.1038/s41467-024-46673-2