We have identified a new human immunodeficiency virus in a Cameroonian woman. It is closely related to gorilla simian immunodeficiency virus (SIVgor) and shows no evidence of recombination with other HIV-1 lineages. This new virus seems to be the prototype of a new HIV-1 lineage that is distinct from HIV-1 groups M, N and O. We propose to designate it HIV-1 group P.

Background. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with a high rate of mortality in patients with end stage renal disease and vaccination is hoped to prevent infection. Methods. Between January 18, and February 24, 2021, 225 kidney transplant recipients (KTR) and 45 hemodialysis patients (HDP) received two injections of mRNA BNT162b2 vaccine. The post-vaccinal humoral and cellular response was explored in the first 45 KTR and 10 HDP. Results. After the second dose, 8 HDP (88.9%) and 8 KTR (17.8%) developed anti-spike SARS-CoV-2 antibodies (p<0.0001). Median titer of antibodies in responders was 1052 AU/mL (IQR: 515-2689) in HDP and 671 AU/mL (IQR: 172-1523) in KTR (p=0.4). Nine HDP (100%) and 26 KTR (57.8%) showed a specific T cell response (p=0.06) after the second injection. In responders, median numbers of spike-reactive T cells were 305 SFC/106 CD3+ T cells (IQR: 95-947) in HDP and 212 SFC/106 CD3+ T cells (IQR: 61-330) in KTR (p=0.4). In KTR, the immune response to BNT162b2 seemed influenced by the immunosuppressive regimen, particularly tacrolimus or belatacept. Conclusion. Immunization with BNT162b2 seems more efficient in HDP, indicating that vaccination should be highly recommended in these patients awaiting a transplant. However, the current vaccinal strategy for KTR may not provide effective protection against COVID-19 and will likely need to be improved.

Significance There is growing evidence that preexisting autoantibodies neutralizing type I interferons (IFNs) are strong determinants of life-threatening COVID-19 pneumonia. It is important to estimate their quantitative impact on COVID-19 mortality upon SARS-CoV-2 infection, by age and sex, as both the prevalence of these autoantibodies and the risk of COVID-19 death increase with age and are higher in men. Using an unvaccinated sample of 1,261 deceased patients and 34,159 individuals from the general population, we found that autoantibodies against type I IFNs strongly increased the SARS-CoV-2 infection fatality rate at all ages, in both men and women. Autoantibodies against type I IFNs are strong and common predictors of life-threatening COVID-19. Testing for these autoantibodies should be considered in the general population.

The limitation of real-time PCR to span the entire diversity of HIV must be taken into account during treatment monitoring, resistance studies, and clinical trials.