Short Communication: Coronavirus Disease 19 Among People Living with HIV in Western India: An Observational Cohort Study

Pujari, Sanjay; Gaikwad, Sunil; Chitalikar, Abhishek; Dabhade, Digamber; Joshi, Kedar; Bele, Vivek

doi:10.1089/aid.2021.0004

Cited by 9 publications

(5 citation statements)

References 15 publications

(16 reference statements)

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“…The hospitalization rate of PLHIV with COVID-19 infection was found to be 14%, which is still within the range of other studies (13.8–58%) [ 9 , 11 , 14 , 15 , 18 ]. This low proportion of hospitalization does not necessarily mean that the number of patients who needed hospitalization was low.…”

Section: Discussionsupporting

confidence: 75%

“…However, these findings must be interpreted cautiously since a recent meta-analysis still found that PLHIV have a higher risk of death compared to non-HIV COVID-19 patients (HR = 1.76, 95% CI 1.31-2.35) [2]. The hospitalization rate of PLHIV with COVID-19 infection was found to be 14%, which is still within the range of other studies (13.8-58%) [9,11,14,15,18]. This low proportion of hospitalization does not necessarily mean that the number of patients who needed hospitalization was low.…”

Section: Discussionmentioning

confidence: 73%

“…Previous studies on factors related to COVID-19 severity among PLHIV showed conflicting results, except for comorbidities, as seen in the non-HIV population [8][9][10]. Some studies have shown that older PLHIV with lower CD4 count have a higher risk of severe outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Incidence and severity prediction score of COVID-19 in people living with HIV (SCOVHIV): experience from the first and second waves of the pandemic in Indonesia

et al. 2022

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Background People living with HIV (PLHIV) have higher risk of COVID-19 infection and mortality due to COVID-19. Health professionals should be able to assess PLHIV who are more likely to develop severe COVID-19 and provide appropriate medical treatment. This study aimed to assess clinical factors associated with COVID-19 severity and developed a scoring system to predict severe COVID-19 infection among PLHIV. Methods This retrospective cohort study evaluated PLHIV at four hospitals diagnosed with COVID-19 during the first and second wave COVID-19 pandemic in Indonesia. The independent risk factors related to the severity of COVID-19 were identified with multivariate logistic regression. Results 342 PLHIV were diagnosed with COVID-19, including 23 with severe-critical diseases. The cumulative incidence up to December 2021 was 0.083 (95% CI 0.074–0.092). Twenty-three patients developed severe-critical COVID-19, and the mortality rate was 3.2% (95% CI 1.61%–5.76%). Having any comorbidity, CD4 count of < 200 cells/mm3, not being on ART, and active opportunistic infection were independent risk factors for developing severe COVID-19. SCOVHIV score was formulated to predict severity, with 1 point for each item. A minimum score of 3 indicated a 58.4% probability of progressing to severe COVID-19. This scoring system had a good discrimination ability with the area under the curve (AUC) of 0.856 (95% CI 0.775–0.936). Conclusion SCOVHIV score, a four-point scoring system, had good accuracy in predicting COVID-19 severity in PLHIV.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 73%

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Incidence and severity prediction score of COVID-19 in people living with HIV (SCOVHIV): experience from the first and second waves of the pandemic in Indonesia

et al. 2022

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“…Of the 43 studies included, 10 studied COVID-19 infections in only PLWH, while one study (68) was designed as a case-control study and was excluded from the metaanalysis [39,40,42,47,48,50,55,56,62,69]. Two studies were identified as duplicate data [27,28] and only the most recent version [27] was included.…”

Section: Prevalence Of Plwh Among Covid-19 Casesmentioning

confidence: 99%

Global and Regional Prevalence and Outcomes of COVID-19 in People Living with HIV: A Systematic Review and Meta-Analysis

et al. 2022

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Background: The relationship between HIV (human immunodeficiency virus) and COVID-19 clinical outcome is uncertain, with conflicting data and hypotheses. We aimed to assess the prevalence of people living with HIV (PLWH) among COVID-19 cases and whether HIV infection affects the risk of severe COVID-19 or related death at the global and continental level. Methods: Electronic databases were systematically searched in July 2021. In total, 966 studies were screened following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Narratives were synthesised and data pooled for the global and continental prevalence of HIV–SARS-CoV-2 coinfection. The relative risks of severity and mortality in HIV-infected COVID-19 patients were computed using a random-effect model. Risk of bias was assessed using the Newcastle–Ottawa score and Egger’s test, and presented as funnel plots. Results: In total, 43 studies were included involving 692,032 COVID-19 cases, of whom 9097 (1.3%) were PLWH. The global prevalence of PLWH among COVID-19 cases was 2% (95% CI = 1.7–2.3%), with the highest prevalence observed in sub-Saharan Africa. The relative risk (RR) of severe COVID-19 in PLWH was significant only in Africa (RR = 1.14, 95% CI = 1.05–1.24), while the relative risk of mortality was 1.5 (95% CI = 1.45–2.03) globally. The calculated global risk showed that HIV infection may be linked with increased COVID-19 death. The between-study heterogeneity was significantly high, while the risk of publication bias was not significant. Conclusions: Although there is a low prevalence of PLWH among COVID-19 cases, HIV infection may increase the severity of COVID-19 in Africa and increase the risk of death globally.

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“…This immune dysregulation might increase the risk of mortality and morbidity associated with COVID-19. Several epidemiological studies have investigated the clinical features and prognosis of COVID-19 among PLWH with inconsistent results, likely due to disparities in comorbidities [ 13 , 14 ]. However, recent studies have indicated that untreated advanced HIV (defined as a low CD4 + T cell count and lack of ART) are associated with more severe clinical outcomes with SARS-CoV-2 infection [ 15 – 17 ].…”

Section: Introductionmentioning

confidence: 99%

Immunological responses in SARS-CoV-2 and HIV co-infection versus SARS-CoV-2 mono-infection: case report of the interplay between SARS-CoV-2 and HIV

Shahbaz,

Sligl,

Osman

et al. 2023

Allergy Asthma Clin Immunol

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Background There is an urgent need to understand the interplay between SARS-CoV-2 and HIV to inform risk-mitigation approaches for HIV-infected individuals. Objectives We conclude that people living with HIV (PLWH) who are antiretroviral therapy (ART) naïve could be at a greater risk of morbidity or mortality once co-infected with SARS-CoV-2. Methods Here, we performed extensive immune phenotyping using flow cytometry. Moreover, to compare the range of values observed in the co-infected case, we have included a larger number of mono-infected cases with SARS-CoV-2. We also quantified soluble co-inhibitory/co-stimulatory molecules in the plasma of our patients. Results We noted a robust immune activation characterized by the expansion of CD8+ T cells expressing co-inhibitory/stimulatory molecules (e.g. PD-1, TIM-3, 2B4, TIGIT, CD39, and ICOS) and activation markers (CD38, CD71, and HLA-DR) in the co-infected case. We further found that neutrophilia was more pronounced at the expense of lymphopenia in the co-infected case. In particular, naïve and central memory CD8+ T cells were scarce as a result of switching to effector and effector memory in the co-infected case. CD8+ T cell effector functions such as cytokine production (e.g. TNF-α and IFN-γ) and cytolytic molecules expression (granzyme B and perforin) following anti-CD3/CD28 or the Spike peptide pool stimulation were more prominent in the co-infected case versus the mono-infected case. We also observed that SARS-CoV-2 alters T cell exhaustion commonly observed in PLWH. Conclusion These findings imply that inadequate immune reconstitution and/or lack of access to ART could dysregulate immune response against SARS-CoV-2 infection, which can result in poor clinical outcomes in PLWH. Our study has implications for prioritizing PLWH in the vaccination program/access to ART in resource-constrained settings.

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Short Communication: Coronavirus Disease 19 Among People Living with HIV in Western India: An Observational Cohort Study

Cited by 9 publications

References 15 publications

Incidence and severity prediction score of COVID-19 in people living with HIV (SCOVHIV): experience from the first and second waves of the pandemic in Indonesia

Incidence and severity prediction score of COVID-19 in people living with HIV (SCOVHIV): experience from the first and second waves of the pandemic in Indonesia

Global and Regional Prevalence and Outcomes of COVID-19 in People Living with HIV: A Systematic Review and Meta-Analysis

Immunological responses in SARS-CoV-2 and HIV co-infection versus SARS-CoV-2 mono-infection: case report of the interplay between SARS-CoV-2 and HIV

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