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mRNA vaccine could clear SARS-CoV-2 virus in persistent cases

People who are hard negative for Covid-19 are clean of the virus after receiving the mRNA vaccine.

REPUBLIKA.CO.ID, JAKARTA — A new case report published in Journal of Clinical Immunology has presented the first description of a COVID-19 mRNA vaccine used to treat patients with persistent SARS-CoV-2 infection. Patient immunocompromised, who repeatedly tested positive for SARS-CoV-2 for more than six months, was finally able to clear the virus from the body after two doses of the mRNA vaccine.

Viral infections are usually characterized as acute or chronic. Chronic viral infections, such as herpes or the Epstein-Barr virus, often go undetected for long periods of time. Viruses can lie dormant for years, sometimes reactivating and causing physiological symptoms and new waves of transmission.

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In some rare cases, those with weakened immune systems can develop chronic viral infections known as persistent infections. In these cases, the virus can remain acutely active for months and the patient consistently experiences negative symptoms and sheds infectious viral particles.

And now, for the first time, mRNA vaccination is used to clear persistent Covid-19 infection. A new study from British researchers reports the case of a 37-year-old man named Ian Lester who developed a persistent SARS-CoV-2 infection, consistently giving a positive PCR test for 218 days. Lester has a rare genetic disease called Wiskott-Aldrich syndrome, and initially he exhibited very mild COVID-19 symptoms.

“Although most people can stop isolating after 10 days of contracting the virus, I can’t. Every time I do the test I come back positive, time and time again. Months went by, what felt like a lifetime of not being able to go anywhere and see friends or family,” said Lester New AtlasThursday (31/3/2022).

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Over time, Lester’s symptoms worsened as he returned to a positive PCR test every two weeks. Blood tests five months after infection showed no antibodies to SARS-CoV-2, indicating his immune system was completely unresponsive to the invading coronavirus. Stephen Jolles, clinical lead at Cardiff University, thinks it’s time to try a more experimental treatment.

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“Given the persistent positive PCR tests and the impact on his health and mental health, we decided on a unique therapeutic approach. We wondered if therapeutic vaccination could help clear the virus by inducing a strong immune response in the body,” said Jolles.

The team gave Lester two doses of Pfizer’s COVID-19 mRNA vaccine, separated by about four weeks. Within 14 days of the first dose of PCR testing showed a marked reduction in the volume of viral material collected by each nasopharyngeal swab. About six weeks after the second dose, Lester tested negative for SARS-CoV-2 for the first time for 218 days.

“It was quite a shocking moment,” said Mark Ponsford, another doctor who worked on the case.

“To our knowledge, this is the first time mRNA vaccination has been used to clear persistent COVID-19 infection. Importantly, the vaccine was well tolerated by patients and succeeded in inducing a strong antibody and T-cell response. This is remarkable considering that Ian’s response to conventional vaccination in the past has been very limited,” he added.

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The case studies are an interesting example of how mRNA vaccines can be used for therapeutic purposes with more traditional prophylactic approaches. Therapeutic vaccines can help induce the immune system to target pre-existing diseases and much of the current research is focused on therapeutic vaccines to target different types of cancer. The new study was published in Journal of Clinical Immunology.

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