SARS-CoV-2 percent positivity and risk factors among people with HIV at an urban academic medical center

Abstract

Since the onset of the COVID-19 pandemic, it has been unclear how vulnerable people with HIV (PwH) are to SARS-CoV-2 infection. We sought to determine if PwH are more likely to test positive for SARS-CoV-2 than people without HIV, and to identify risk factors associated with SARS-CoV-2 positivity among PwH. We conducted a cross-sectional study in which we collected electronic medical record data for all patients who underwent SARS-CoV-2 PCR testing at an academic medical center. Presence of HIV and other chronic diseases were based on the presence of ICD-10 diagnosis codes. We calculated the percent positivity for SARS-CoV-2 among PwH and among people without HIV. Among PwH, we compared demographic factors, comorbidities, HIV viral load, CD4 T-cell count, and antiretroviral therapy (ART) regimens between those who tested positive for SARS-CoV-2 and those who tested negative. Comparisons were made using chi squared tests or Wilcoxon rank sum tests. Multivariate models were created using logistic regression. Among 69,763 people tested for SARS-CoV-2, 0.6% (431) were PwH. PwH were not significantly more likely to test positive for SARS-CoV-2 than people without HIV (7.2% (31/431) vs 8.4% (5820/69763), p = 0.35), but were more likely to be younger, Black, and male (p-values < .0001). There were no significant differences in HIV clinical factors, chronic diseases, or ART regimens among PwH testing positive for SARS-CoV-2 versus those testing negative. In our sample, PwH were not more likely to contract SARS-CoV-2, despite being more likely to be members of demographic groups known to be at higher risk for infection. Differences between PwH who tested positive for SARS-CoV-2 and those who tested negative were only seen in Hispanic/Latino ethnicity (non-Hispanic or Latino vs unknown Hispanic or Latino ethnicity (OR 0.2 95% CI (0.6, 0.9)) and site of testing(inpatient vs outpatient OR 3.1 95% CI (1.3, 7.4)).

Evaluation of SARS-CoV-2 diagnostics and risk factors associated with SARS-CoV-2 infection in Zambia

“…In our study, 78% (68/87) of the participants presented with hypertension, HIV, diabetes, Tuberculosis (Tegally et al), and chronic pulmonary disease. Suspected cases who had HIV were not at increased risk of SARS-CoV-2 positivity, consistent with previous studies ( Charre et al, 2020, Friedman et al, 2021, Inciarte et al, 2020. Our study was underpowered to evaluate whether HIV-infected cases had worse outcomes, but studies elsewhere have suggested HIV is not associated with worse outcomes ( Cooper et al, 2020, Nagarakanti et al, 2021.…”

High Asymptomatic Carriage With the Omicron Variant in South Africa

“…The data are provocative because the cutoff point was seen at the relatively high level of <500 cells/mm 3 , although more data are needed to validate this finding. Prior studies largely conducted during ancestral strain time periods have not found an increased prevalence of SARS-CoV-2 among PWH compared to HIV-uninfected people [ 13–16 ]. VoC that exhibit levels of resistance to the immunodominant epitopes associated with immune protection may be a factor in these differences [ 17 ].…”

Age and Racial Disparities in Telehealth Use Among People with HIV During the COVID-19 Pandemic

“…It is also possible that PwH acquiring SARS-CoV-2 was a factor that drove telehealth use among PwH. We have previously examined patterns in SARS-CoV-2 testing among PwH at our institution during this time period and found that overall SARS-CoV-2 positivity among PwH was 7.2% [ 28 ]. Most of these patients were Black (90.3%) and had a median age of 49 (34–59) years of age, suggesting to us that it is unlikely that infection with SARS CoV-2 is responsible for the racial disparity in telehealth use that we observed.…”