HTB

HIV positive people at higher risk of worse outcomes from COVID-19 in UK study

Simon Collins, HIV i-Base

Results from a prospective observational database study report that being HIV positive is associated with higher risks of 28-day mortality. [1]

The study as published on 23 October in Clinical Infectious Diseases and included results from more than 47,500 people hospitalised with COVID-19, of which 122 (0.26%) had a recorded HIV diagnosis.

In unadjusted analyses, cumulative risk of mortality was similar in the HIV positive vs HIV negative groups (26.7% vs. 32.1% respectively; p=0.16).

However, the HIV positive group was significantly younger (median 56 versus 74 years; p<0.001) and had more comorbidities.

After adjustment for these and other factors, mortality was higher among people with HIV (aHR: 1.47; 95% CI: 1.01 to 2.14; p=0.05). This association became stronger after adjusting for the other factors (aHR 1.69; 95% CI 1.15 to 2.48; p=0.008) and when restricting the analysis to people aged <60 years (aHR 2.87; 95% CI 1.70-4.84; p<0.001).

comment

This study was previously reported in HTB ahead of peer review. [2]

It is important to show the importance of adjusting for the significant differences in HIV positive and negative cases.

This in turn should caution advice for HIV positive people to not rely on a lower age as protection against COVID-19 and also perhaps for HIV-positive people older than 60 to be even more careful to follow prevention advice to avoid catching COVID-19.

References

  1. Geretti AM et al. Outcomes of COVID-19 related hospitalization among people with HIV in the ISARIC WHO clinical characterization protocol (UK): a prospective observational study. Clinical Infectious Diseases, ciaa1605, DOI: 10.1093/cid/ciaa1605. (23 October 2020).
    https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa1605/5937133
  2. Collins S. HIV associated with worse outcomes from COVID-19 in UK ISARIC and OpenSAFELY databases. HTB (28 August 2020).
    https://i-base.info/htb/38726

This report was first posted on 28 October 2020.

Links to other websites are current at date of posting but not maintained.