Le variant Omicron présente un nombre de mutations ahurissant. Plus d’une trentaine dans la protéine Spike ! Celle-ci est la clé du virus pour entrer dans les cellules humaines et la cible des vaccins. Ce grand nombre de mutations a amené l’OMS à classer le variant comme « préoccupant ». Mais comment ce variant a-t-il pu muter autant ?
Depuis le début de la pandémie, les variants se succèdent, toujours plus contagieux et toujours plus dangereux. Le tout dernier, Omicron, apparu en Afrique du Sud, présente un nombre de mutations anormalement élevé. Il se pourrait bien que le SARS-CoV-2 trouve des conditions particulièrement propices aux mutations chez les patients immunodéprimés, en particulier les patients atteints du Sida et non correctement traités.
Une hypothèse originale
Tulio de Oliveira, un scientifique sud-africain, a émis une hypothèse originale : une personne atteinte du VIH pourrait être à l’origine de l’émergence du variant Omicron en Afrique du Sud. En effet, il a été observé que le virus mutait chez des personnes non correctement traitées pour leur Sida et immunodéprimées. En particulier, une jeune femme de 36 ans, atteinte du VIH et immunodéprimée, a été en contact avec le SARS-CoV-2 et est demeurée porteuse du virus pendant 216 jours ! Une durée aussi longue ne représente pas la norme : la plupart des patients guérissent en quelques semaines ou bien décèdent.
Il est possible que le fait que le virus SARS-CoV-2 ait persisté aussi longtemps dans le corps humain ait favorisé un grand nombre de mutations. Des observations similaires ont été faites par des médecins aux États-Unis et en Europe. Le virus mutait chez des patients immunodéprimés à la suite d’un traitement contre le cancer ou d’un traitement immunosuppresseur après une greffe d’organe. En effet, plus le virus reste longtemps dans le corps du patient, plus il se réplique et plus le risque d’erreurs de réplication est grand. C’est là qu’apparaissent les mutations et que naissent les variants.
Bien sûr, d’autres hypothèses sont possibles pour expliquer l’apparition du variant Omicron. Les mutations sont peut être apparues très progressivement, sans être détectées, par défaut de séquençage. Il est également possible que le virus soit passé par un hôte animal avant d’être de nouveau transmis à l’Homme.
Lutter contre le SARS-CoV-2… mais aussi contre le VIH !
Si l’hypothèse de Tulio de Oliveira est confirmée, il faudra désormais incorporer dans la lutte contre le SARS-CoV-2 la lutte contre l’immunodépression. En Afrique, la cause principale d’immunodépression est le VIH.
L’Afrique sub-saharienne compte près de 8 millions de personnes infectées par le VIH, non correctement traitées et la plupart du temps non vaccinées contre la Covid-19. Ces personnes immunodéprimées sont de potentiels incubateurs de variants du SARS-CoV-2. Rappelons que seulement 7 % de la population africaine est vaccinée contre le SARS-CoV-2. Il ne s’agit plus seulement de donner des vaccins à l’Afrique mais aussi des traitements préventifs ou curatifs contre le Sida. La lutte contre le SARS-CoV-2 doit être mondiale pour être efficace.
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