UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Prolonged SARS-CoV-2 shedding in a person living with advanced HIV and diffuse large B-cell lymphoma: a case report

Maan, Irfaan; Paraskevopoulou, Stavroula Maria; Cwynarski, Kate; Shrestha, Meena; Waters, Laura; Miller, Robert; Ahmed, Nadia; (2022) Prolonged SARS-CoV-2 shedding in a person living with advanced HIV and diffuse large B-cell lymphoma: a case report. Infectious Diseases , 54 (7) pp. 529-533. 10.1080/23744235.2022.2055136. Green open access

[thumbnail of Maan_Finalised Manuscript 221221-2.pdf]
Preview
Text
Maan_Finalised Manuscript 221221-2.pdf

Download (147kB) | Preview

Abstract

BACKGROUND: The global spread of SARS-CoV-2 has necessitated case isolation, with recommended isolation times based on mean time to viral clearance. CASE STUDY: We present a 28-year-old female living with vertically acquired HIV, undergoing chemotherapy for lymphoma who tested SARS-CoV-2-PCR positive for 164 days. The patient had a history of difficulty taking ARVs, with detectable HIV-RNA and CD4 count below 200 × 106 for the 8 years prior to presentation with symptoms. She stopped ARVs 10 months prior to experiencing fevers, night sweats and loose stool, with a viral load of 354,000 copies/ml and CD4 count of 30 × 106. Following no yield on basic investigations, positron emission tomography scan showed diffuse colonic and oesophageal avidity and a caecal biopsy showed diffuse large B-cell lymphoma. She re-started ARVs and underwent five cycles of R-CHOP chemotherapy. Her first positive SARS-CoV-2 PCR test was detected through routine asymptomatic screening. She self-isolated due to repeated positive tests on a further 8 swabs for a total of 164 days until a negative PCR test. She reported feeling low in mood and frustrated by repeated positive tests and the associated lack of social contact or ability to work. Her positive tests prevented in-person review by her HIV team, which impacted her ARV adherence leading to an unplanned break in therapy. CONCLUSIONS: Our case highlights the challenges to physical and mental health faced by patients with prolonged SARS-CoV-2 shedding and the need to develop surrogate markers for infectivity to enable prompt medical and psychological support and accurate advice about the need for isolation.

Type: Article
Title: Prolonged SARS-CoV-2 shedding in a person living with advanced HIV and diffuse large B-cell lymphoma: a case report
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1080/23744235.2022.2055136
Publisher version: https://doi.org/10.1080/23744235.2022.2055136
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: COVID-19, HIV, SARS-CoV-2, immunocompromised patients, lymphoma, viral shedding
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10147227
Downloads since deposit
91Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item