COVID-19 in people living with HIV: A multicenter case-series study

Cabello, Alfonso; Zamarro, Belén; Nistal, Sara; Víctor, Virginia; Hernandez, J. J. G.; Prieto-Pérez, Laura; Carrillo, Irene; Álvarez, Beatriz; Fernández-Roblas, R.; Hernández-Segurado, Marta; Becares, Javier; Benito, José M.; Rallón, Norma; Téllez, Raquel; Castaño, Ángel Luís; Herrero, Antonio; Górgolas, Miguel

doi:10.1016/j.ijid.2020.10.060

Cited by 44 publications

(57 citation statements)

References 24 publications

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“…5,40 In instances when outpatients were included, overall rates of ICU admission ranged between 3% and 22%. 57,64 As previously explained, severe illness increases with age and multimorbidities, and is increased in men, 11,12 with multimorbidities being reported in nearly two-thirds of patients coinfected with HIV and SARS-CoV-2. 12 The risk of mortality in hospitalised patients in the UK showed an adjusted hazard ratio of 1•69 (95% CI 1•15-2•48; p=0•008), 5 whereas in the UK, in primary care alone, after adjustment for age, sex, deprivation, ethnicity, smoking and obesity, the adjusted hazard ratio was 2•59 (1•74-3•84; p<0•0001).…”

Section: Prognostic Factors For Icu Admission and Deathmentioning

confidence: 89%

“…Since the first reported series of COVID-19 in people living with HIV, 8 a stream of single-centre or multicentre case-series have been published. 13 , 37 , 40 , 41 , 57 , 58 , 59 , 60 , 61 , 62 , 63 These series report epidemiological features, clinical presentation, and outcomes in people living with HIV ( table 1 ). Globally, the initial series showed no clear evidence for higher COVID-19 infection rates or different disease course in people living with HIV.…”

Section: Clinical Manifestations and Disease Progressionmentioning

confidence: 99%

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Overview of SARS-CoV-2 infection in adults living with HIV

et al. 2021

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Section: Prognostic Factors For Icu Admission and Deathmentioning

confidence: 89%

Section: Clinical Manifestations and Disease Progressionmentioning

confidence: 99%

Overview of SARS-CoV-2 infection in adults living with HIV

et al. 2021

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Section: Introductionmentioning

confidence: 99%

“…Furthermore, there are limited published reports from Africa on the immunogenicity of any COVID-19 vaccine 9 . PLWH are at greater risk for infectious diseases such as in uenza, including while being treated with antiretroviral treatment (ART) [17][18][19] , and are at higher risk for severe COVID-19 disease following SARS-CoV-2 exposure compared with HIV-negative individuals 3,[20][21][22][23][24] .The Centers for Disease Control and Prevention (CDC) advises that PLWH can choose to be vaccinated against COVID-19, but may have reduced immune responses to the vaccine 25 , while the World Health Organization recommends that PLWH are to be immunized with COVID-19 vaccines 26,27 . Although there are an estimated 38 million PLWH globally, there is limited knowledge on the safety and immunogenicity of COVID-19 vaccines in PLWH.…”

mentioning

confidence: 99%

ChAdOx1 nCoV-19 (AZD1222) Vaccine in People Living With and Without HIV

Madhi

Koen

Fairlie

et al. 2021

Preprint

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Coronavirus disease 2019 (COVID-19) is a public health emergency of international concern1. People living with HIV (PLWH) are at increased risk for adverse COVID-19 outcomes compared with HIV-negative individuals2-5, and are a high-risk group for COVID-19 prevention4. The ChAdOx1 nCoV-19 (AZD1222) vaccine has demonstrated safety and efficacy against COVID-19 in clinical trials6-8. To date, there are no reports on the safety and immunogenicity of this, or any COVID-19 vaccine, in PLWH, and reports on the immunogenicity of COVID-19 vaccines in Africa are limited9. Here, we show comparable safety and immunogenicity of two doses of ChAdOx1 nCoV-19 between PLWH and HIV-negative individuals in South Africa. Furthermore, in PLWH previously exposed to SARS-CoV-2, antibody responses increased substantially from baseline following a priming dose, with modest increases after a booster dose. Full-length spike and receptor-binding domain IgG geometric mean concentrations after a single dose of ChAdOx1 nCoV-19 in PLWH previously exposed to SARS-CoV-2 were 6.49–6.84-fold higher than after two doses in those who were SARS-CoV-2 naïve at enrollment. Neutralizing antibody responses were consistent with the antibody-binding responses. This is the first report of a COVID-19 vaccine specific to PLWH, and specific to Africa, and demonstrates favorable safety and immunogenicity of ChAdOx1 nCoV-19 in PLWH.

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“…A number of clinical studies have examined interaction between HIV-1 and SARS-CoV-2: mostly cohorts lacking HIV-1-or SARS-CoV-2-uninfected control participants [12][13][14][15][16][17][18][19][20][21] . Definitive conclusions are thus difficult to reach but the presentation and outcome of SARS-CoV-2 in HIV-1 co-infected patients is reported as not differing greatly from that in HIV-1 uninfected persons [22][23][24] .…”

mentioning

confidence: 99%

Communicable and non-communicable co-morbidities and the presentation of COVID-19 in an African setting of high HIV-1 and tuberculosis prevalence

Bruyn

Stek

Daroowala

et al. 2021

Preprint

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Objectives To describe the presentation and outcome of SARS–CoV2 infection in an African setting of high non–communicable co–morbidity and also HIV–1 and tuberculosis prevalence. Design Case control analysis with cases stratified by HIV–1 and tuberculosis status. Setting A single–centre observational case–control study of adults admitted to a South African hospital with proven SARS–CoV–2 infection or alternative diagnosis. Participants 104 adults with RT–PCR–proven SARS–CoV2 infection of which 55 (52.9%) were male and 31 (29.8%) HIV–1 co–infected. 40 adults (35.7% male, 30.9% HIV–1 co–infected) admitted during the same period with no RT–PCR or serological evidence of SARS–CoV2 infection and assigned alternative diagnoses. Additional in vitro data from prior studies of 72 healthy controls and 118 HIV–1 uninfected and infected persons participants enrolled to a prior study with either immune evidence of tuberculosis sensitization but no symptoms or microbiologically confirmed pulmonary tuberculosis. Results Two or more co–morbidities were present in 57.7% of 104 RT–PCR proven COVID–19 presentations, the commonest being hypertension (48%), type 2 diabetes mellitus (39%), obesity (31%) but also HIV–1 (30%) and active tuberculosis (14%). Amongst patients dually infected by tuberculosis and SARS–CoV–2, clinical features could be dominated by either SARS–CoV–2 or tuberculosis: lymphopenia was exacerbated, and some markers of inflammation (D–dimer and ferritin) elevated in singly SARS–CoV–2 infected patients were even further elevated (p less than 0.05). HIV–1 and SARS–CoV2 co–infection resulted in lower absolute number and proportion of CD4 lymphocytes, with those in the lowest peripheral CD4 percentage strata exhibiting absent or lower antibody responses against SARS–CoV2. Death occurred in 30/104 (29%) of all COVID–19 patients and in 6/15 (40%) of patients with coincident SARS–CoV–2 and tuberculosis. Conclusions In this South African setting, HIV–1 and tuberculosis are common co–morbidities in patients presenting with COVID–19. In environments in which tuberculosis is common, SARS–CoV–2 and tuberculosis may co–exist with clinical presentation being typical of either disease. Clinical suspicion of exacerbation of co–existent tuberculosis accompanying SARS–CoV–2 should be high.

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COVID-19 in people living with HIV: A multicenter case-series study

Abstract: Graphical Abstract

Cited by 44 publications

References 24 publications

Overview of SARS-CoV-2 infection in adults living with HIV

Overview of SARS-CoV-2 infection in adults living with HIV

ChAdOx1 nCoV-19 (AZD1222) Vaccine in People Living With and Without HIV

Communicable and non-communicable co-morbidities and the presentation of COVID-19 in an African setting of high HIV-1 and tuberculosis prevalence

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