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Antigenic evolution of SARS-CoV-2 in immunocompromised hosts.
Cameron A Smith1, Ben Ashby1,2,3
1Department of Mathematical Sciences, University of Bath, Bath, BA2 7AY, UK.
Evolution, Medicine, and Public Health
|April 3, 2023
Summary
Immunocompromised individuals do not qualitatively affect SARS-CoV-2 evolution without epistasis. However, persistent infections in these individuals facilitate immune escape variant emergence when epistasis is present.
Area of Science:
- Virology
- Evolutionary Biology
- Immunology
Background:
- Prolonged SARS-CoV-2 infections in immunocompromised individuals are suspected to drive new variant emergence.
- The role of immunocompromised hosts in pathogen evolution, particularly for immune escape variants, remains poorly understood.
Purpose of the Study:
- To investigate the impact of immunocompromised hosts on the emergence of SARS-CoV-2 immune escape variants.
- To analyze these effects in scenarios with and without epistasis.
Main Methods:
- Utilized a mathematical modeling approach.
- Simulated pathogen evolution within hosts and between hosts.
Main Results:
- Without epistasis, immunocompromised hosts do not qualitatively alter antigenic evolution, though they may accelerate it.
- With epistasis, persistent infections in immunocompromised individuals facilitate the accumulation of mutations, promoting antigenic evolution.
Conclusions:
- Persistent infections in immunocompromised individuals play a critical role in facilitating immune escape variant evolution when epistasis is present.
- Enhanced genomic surveillance and improved global health equity, including access to vaccines and treatments for immunocompromised individuals, are vital for preventing future variant emergence.
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