Background Within the ongoing AGEhIV Cohort Study in Amsterdam, we prospectively compared the incidence of and risk factors for SARS-CoV-2 infection between HIV-positive and -negative participants. Moreover, we compared SARS-CoV-2 nucleocapsid antibody levels between participants with incident infection from both groups. Methods Starting in September 2020, consenting HIV-positive and HIV-negative participants were assessed 6-monthly for incident SARS-CoV-2 infection, using combined IgA/IgM/IgG SARS-CoV-2 nucleocapsid antibody assay. Cumulative incidence of SARS-CoV-2 infection and associated risk factors were assessed from February 27, 2020 through April 30, 2021 using complementary log-log regression. In those with incident SARS-CoV-2 infection, N-antibody levels were compared between groups using linear regression. Results 241 HIV-positive (99.2% virally suppressed) and 326 HIV-negative AGEhIV participants were included in this study. Cumulative SARS-CoV-2 incidence by April 2021 was 13.4% and 11.6% in HIV-positive and HIV-negative participants, respectively (p=0.61). Younger age and African origin were independently associated with incident infection. In those with incident infection, only self-reported fever, but not HIV status, was associated with higher N-antibody levels. Conclusions HIV-positive individuals with suppressed viremia and adequate CD4 cell counts were had similar risk of SARS-CoV-2 acquisition, and had similar SARS-CoV-2 N-antibody levels following infection compared to a comparable cohort of HIV-negative people.

Background We determined the frequency of and factors associated with ≥10% weight gain and its metabolic effects in virally suppressed people with HIV (PWH) from the Dutch national ATHENA cohort switching to TAF and/or INSTI. Methods We identified ART-experienced, but TAF/INSTI-naïve PWH, who switched to a TAF and/or INSTI-containing regimen whilst virally suppressed for >12 months. Individuals with comorbidities/co-medication associated with weight change were excluded. Analyses were stratified by switch to only TAF, only INSTI or combined TAF + INSTI. Factors associated with ≥10% weight gain were assessed using parametric survival models. Changes in glucose, lipids and blood pressure post-switch were modelled using mixed-effect linear regression and compared between those with and without ≥10% weight gain. Results Among 1,544 PWH who switched to only TAF, 2,629 to only INSTI and 918 to combined TAF + INSTI, ≥10% weight gain was observed in 8.8%, 10.6% and 14.4%, respectively. Across these groups, weight gain was more frequent in Western and Sub-Saharan African females than Western males. Weight gain was also more frequent in those with weight loss ≥1 kg/yr before switching, age < 40 years, and those discontinuing efavirenz. In those with ≥10% weight gain, 53.7% remained in the same BMI category, whilst a BMI change from normal/overweight at baseline to obesity at 24 months post-switch was seen in 13.9%, 11.7% and 15.2% of those switching to only TAF, only INSTI and combined TAF + INSTI respectively. PWH with ≥10% weight gain showed significantly larger, but small increases in glucose, blood pressure and lipid levels. Lipid increases were limited to those whose switch included TAF, whereas lipids decreased after switching to only INSTI. Conclusions Weight gain of ≥10% after switch to TAF and/or INSTI was common in virally suppressed PWH, particularly in females and those starting both drugs simultaneously. Consequent changes in metabolic parameters were however modest.

In two Dutch observational cohorts of people with HIV, the use of TDF, ETR, or INSTIs was not independently associated with either the risk of incident SARS-CoV-2 infection or severe COVID-19 outcomes, as was suggested by previous observational and molecular docking studies. Our findings do not support a strategy of modifying antiretroviral therapy to include these agents to protect against SARS-CoV-2 infection and severe COVID-19 outcomes.

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Some studies have suggested that people with HIV may respond less well to vaccines against SARS-CoV-2. We comprehensively compared B- and T-cell responses to different COVID-19 vaccines in middle-aged persons with well-treated HIV and individuals of the same age without HIV, who were also highly comparable in terms of demographics and lifestyle, including those with prior SARS-CoV-2 infection.

Background: Little is known about the impact of social distancing on health-related quality of life and depressive symptoms in older people with HIV during the COVID-19 pandemic.Setting: HIV-positive and HIV-negative AGE h IV Cohort Study participants. Method:In September-November 2020, participants completed questionnaires on social distancing, change in substance use, healthrelated quality of life (EQ-6D, including EQ-VAS), and depressive symptoms . Associations between social distancing and (1) EQ-VAS or (2) PHQ-9 score $10 (clinically relevant depressive symptoms) were analyzed using fractional and binomial logistic regression, respectively.Results: Two hundred fourteen HIV-positive and 285 HIV-negative participants were analyzed. 77.4% found social distancing important and 66.9% reported good adherence to these measures, without significant differences between HIV-positive and HIV-negative participants. In both groups, ,5% reported increased smoking or recreational drug use, but more HIV-positive (12.2%) than HIV-negative (4.9%) participants (P = 0.005) reported increased/more frequent alcohol use. Median EQ-VAS was slightly lower in HIV-positive (80 IQR = 73-90) than HIVnegative (84 IQR = 75-90) participants (P = 0.041). The prevalence of clinically relevant depressive symptoms was similar (HIV-positive, 8.4% and HIV-negative, 8.8%). Worrying about contracting COVID-19 and having $3 (vs no) comorbidities were associated with lower EQ-VAS and finding social distancing easy with higher EQ-VAS. Worrying about contracting COVID-19 and younger than 60 years (vs $65) were associated with higher odds of clinically relevant depressive symptoms. HIV status was associated with neither outcome. Conclusions:Initially during the COVID-19 pandemic in the Netherlands, a similar majority of HIV-positive and HIV-negative participants reported adhering to social distancing. Irrespective of HIV status, concerns about contracting COVID-19 negatively affected participants' perceived current health and increased risk of depressive symptoms.

Objective: We aimed to determine the reversibility of ≥7% weight gain (WG) within 12 months following TAF- and/or INSTI-discontinuation in people with HIV (PWH) from the Dutch ATHENA cohort. Design and methods: PWH with ≥7% WG within 24 months after first switch to TAF and/or INSTI whilst being virally suppressed were selected, excluding those with comorbidities/co-medication known to be associated with WG. PWH who discontinued only TAF, only INSTI or TAF+INSTI, with available follow-up weight, were included. Mean weight change in the 24 months prior to and 12 months after discontinuation was modelled using mixed-effects linear regression. Factors associated with yearly weight change were assessed using linear regression. Results: In 115 PWH, discontinuing only TAF (n = 39), only INSTI (n = 53) or TAF+INSTI (n = 23), the adjusted mean modelled weight change in the 24 months prior to discontinuation was +4.50 kg [95%CI, 3.04–6.10], +4.80 kg [95%CI, 2.43–7.03] and +4.13 kg [95%CI, 1.50–7.13], respectively, and -1.89 kg [95%CI, -3.40 to -0.37], -1.93 kg [95%CI, -3.92 to +0.07] and -2.55 kg [95%CI, -5.80 to +0.02] in the 12 months post-discontinuation. A greater number of years since HIV diagnosis was associated with greater reversibility of WG. No associations were found between weight change post-discontinuation and changes in NRTI backbone or anchor agent at moment of discontinuation. Conclusions: There was no evidence of rapid reversibility of ≥7% TAF- and/or INSTI-associated WG after discontinuation of these agents. Studies of larger and more diverse populations of PWH are required to more fully understand the degree to which WG is reversible when discontinuing TAF and/or INSTI.

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