{"id":38257,"date":"2020-06-26T07:40:26","date_gmt":"2020-06-26T07:40:26","guid":{"rendered":"http:\/\/i-base.info\/htb\/?p=38257"},"modified":"2020-07-29T16:12:17","modified_gmt":"2020-07-29T16:12:17","slug":"latest-data-on-hiv-covid-19-coinfection","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/38257","title":{"rendered":"Latest studies on HIV\/COVID-19 coinfection"},"content":{"rendered":"

<\/span>Simon Collins, HIV i-Base<\/strong><\/p>\n

The last issue of HTB included a review of approximately 20 published papers on HIV\/COVID-19 coinfection. [1]<\/strong><\/p>\n

In the last few weeks another eight papers have been published, from the US, China, and South Africa. [2, 3, 4, 5, 6, 7, 8, 9]<\/p>\n

Although many of these are still relatively small cohorts, some report poorer outcomes, likely due to comorbidities and higher risk factors.<\/p>\n

The results from South Africa, however, are important for providing the first large cohort from a country with high prevalence of both HIV and TB. The higher mortality from COVID-19 in people living with HIV in this study is controversial and are likely to be explained by issues specific to health care in South Africa.\u00a0These data are reported in full in a separate article in this issue by Polly Clayden. [10]<\/p>\n

Table 1: Recent studies reporting HIV\/COVID-19 coinfection<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n\n
Lead author<\/td>\nNotes<\/td>\nN<\/td>\nRefs<\/td>\n<\/tr>\n
Okoh AK et al.<\/td>\n15 men, 12 women in Newark, New Jersey, US. Median age 58 years (IQR: 50 to 67), 25\/27 were African American and 2\/27 were Hispanic. Med. CD4 551 (IQR: 286, 710). Common comorbidities included hypertension (59%), diabetes mellitus (33%) and chronic kidney disease (27%). Three required ICU. The two deaths were complicated by septic shock and multi-organ dysfunction.<\/td>\n27 HIV+.\n

13\/27 hospitalised.<\/p>\n

2\/27 died.<\/p><\/td>\n

2<\/td>\n<\/tr>\n
Ridgway JS et al.<\/td>\nN=5 Chicago, 4 women, 1 man. 4\/5 African American. Median age 48 (range 38 to 53). All on effective ART with CD4 >200. 2\/5 needed supplemental oxygen, but not mechanical ventilation. All discharged.<\/td>\nN=5 HIV+\n

All survived.<\/p><\/td>\n

3<\/td>\n<\/tr>\n
Hu Y et al.<\/td>\nN=12 (10 men, 2 women) from Wuhan, China. Median age 36 (IQR: 33 to 56; range 25 to 66). All on ART.\n

Plus 2 men (age 25 and 37) diagnosed with late-stage HIV in hospital.<\/p>\n

Cases found using LGBT database and then by telephone contact.<\/p>\n<\/td>\n

N=14 HIV+ including 2 only diagnosed in hospital.\n

1\/12 died (56 year old man who died at home).<\/p><\/td>\n

4<\/td>\n<\/tr>\n
Karmen-Tuohy S et al.<\/td>\nCase-control study of 21 HIV+ to 42 HIV negative with COVID-19 in NYC, matched for comorbidities. Median age 60. 23% African American.\n

Reported similar outcomes. 3\/21 died. Need larger study.<\/p><\/td>\n

N=21 HIV+.\n

3\/12 died.<\/p><\/td>\n

5<\/td>\n<\/tr>\n
Shekhar R et al.<\/td>\nOut of 125 patients at centre in New Mexico, only 5\/125 (4%) were HIV+ (4 men, 1 woman). \u00a03\/5 hospitalised, 2\/3 with thromboembolic events. All survived.<\/td>\nN=5 HIV+ (4%).\n

All survived.<\/p><\/td>\n

6<\/td>\n<\/tr>\n
Calzo L et al.<\/td>\nProspective observational study in 14 HIV+ with COVID-19 (9 men, 5 women) to study immune and viral responses, all on ART (13\/14 with undetectable VL). Median age 52. Median CD4 count 612 cells\/mm3<\/sup> (IQR: 339, 886). 9\/14 (64%) had one or more comorbidities. All recovered. No ICU admissions and no deaths.<\/td>\n14 HIV+.\n

No ICU, no deaths.<\/p><\/td>\n

7<\/td>\n<\/tr>\n
Shalev N et al.<\/td>\nRetrospective review of 31 HIV+ from all 2159 adults (1.4%) at single centre for tertiary care in NYC.\n

Mean age 60 (range, 23 to 89 years); 24 men and 7 women. Approx 52% non-Hispanic black, 29% Hispanic of any race, and 16) non-Hispanic white. 22\/31 (71%) had at least one comorbidity.<\/p>\n

Mean CD4 396 (range: 89 to 924). VL <50 in 96%.<\/p>\n

8\/31 (25.8%) died and 2 (6.5%) were still in ICU. 4\/8 were >65 years and 4 were between 50 and 65.<\/p><\/td>\n

N=31.\n

8\/31 died (25%) with 2 still on ICU at time of analysis.<\/p><\/td>\n

8<\/td>\n<\/tr>\n
Davies MA et al.<\/td>\nSouth African review of 12,987 COVID-19 cases in the public sector. Of 435 deaths, 52% were associated with diabetes, 12% with HIV, 2% to active TB and 4% to historical TB.\n

HIV associated with 2-3-fold higher risk of death compared to 13-fold higher with uncontrolled diabetes.<\/p><\/td>\n

Large public health database of 12,987 COVID-19 cases. 2-3-fold higher mortality associated with HIV.\n

Likely explained by factors specific to south African setting.<\/p><\/td>\n

9<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

This article was first published online on 23 June 2020.<\/em><\/p>\n

References<\/p>\n

    \n
  1. Collins S. HIV and COVID-19 coinfection: case reports, retrospective cohorts and outcomes. HTB, HIV\/COVID-19 supplement (4). (1 June 2020).
    \nhttps:\/\/i-base.info\/htb\/38000<\/a><\/li>\n
  2. Okoh AK et al. COVID-19 pneumonia in patients with\u00a0HIV\u00a0\u2013 a case series. JAIDS, ahead of print.Letter. DOI: 10.1097\/QAI.0000000000002411. (28 May 2020).
    \n    https:\/\/journals.lww.com\/jaids\/Citation\/9000\/COVID_19_pneumonia_in_patients_with_HIV___A_Case.96163.aspx<\/a><\/li>\n
  3. Ridgway JS et al. A case series of five people living with HIV hospitalized with COVID-19 in Chicago, Illinois. AIDS Patient Care and STDs. DOI: 10.1089\/apc.2020.0103. (29 May 2020).
    \n    https:\/\/www.liebertpub.com\/doi\/10.1089\/apc.2020.0103<\/a><\/li>\n
  4. Hu Y et al. Coinfection with\u00a0HIV\u00a0and\u00a0SARS-CoV-2\u00a0in Wuhan,\u00a0China: a 12-person case series. JAIDS, ahead of print.DOI: 10.1097\/QAI.0000000000002424. (12 June 2020).
    \n    https:\/\/journals.lww.com\/jaids\/Abstract\/9000\/Coinfection_with_HIV_and_SARS_CoV_2_in_Wuhan,.96153.aspx<\/a><\/li>\n
  5. Karmen-Tuohy S et al. Outcomes among\u00a0HIV-positive patients hospitalized with\u00a0COVID-19. JAIDS. DOI: 10.1097\/QAI.0000000000002423.
    \n    https:\/\/journals.lww.com\/jaids\/Abstract\/9000\/Outcomes_among_HIV_positive_patients_hospitalized.96152.aspx<\/a><\/li>\n
  6. Shekhar R et al. Coronavirus disease of 2019 in patients with well-controlled HIV on Antiretroviral Therapy. JAIDS, ahead of print. DOI: 10.1097\/QAI.0000000000002415. (18 June 2020).
    \n    https:\/\/journals.lww.com\/jaids\/Citation\/9000\/Coronavirus_Disease_of_2019_in_Patients_with.96147.aspx<\/a><\/li>\n
  7. Calzo L et al. No significant effect of COVID-19 on immunological and virological parameters in patients with\u00a0HIV-1 infection. JAIDS, ahead of print. DOI: 10.1097\/QAI.0000000000002427. (19 June 2020).
    \n    https:\/\/journals.lww.com\/jaids\/Citation\/9000\/NO_SIGNIFICANT_EFFECT_OF_COVID_19_ON_IMMUNOLOGICAL.96150.aspx<\/a><\/li>\n
  8. Shalev N et al. Clinical characteristics and outcomes in people living with HIV hospitalized for COVID-19. Clinical Infectious Diseases, ciaa635. DOI: 10.1093\/cid\/ciaa635. (30 May 2020).
    \n    https:\/\/academic.oup.com\/cid\/advance-article\/doi\/10.1093\/cid\/ciaa635\/5848754<\/a><\/li>\n
  9. Davies MA et al. Western Cape: COVID-19 and HIV\/tuberculosis. Webinar: when epidemics collide. Bhekisisa Centre for Health Journalism. 9 June 2020.
    \n    https:\/\/bhekisisa.org\/multimedia\/2020-06-09-standing-by-when-epidemics-collide-does-hiv-tb-cause-worse-covid-19<\/a>\/(webinar)
    \n    https:\/\/storage.googleapis.com\/stateless-bhekisisa-website\/wordpress-uploads\/2020\/06\/94d3ea42-covid_update_bhekisisa_wc_3.pdf (Mary-Ann Davies\u2019 presentation pdf<\/a>)<\/li>\n
  10. Clayden P. HIV positive people in South Africa at increased risk of dying from COVID-19: first data from country with high prevalence of HIV and TB. HTB. (17 June 2020).
    \n    https:\/\/i-base.info\/htb\/38232<\/a><\/li>\n<\/ol>\n\n","protected":false},"excerpt":{"rendered":"

    Simon Collins, HIV i-Base The last issue of HTB included a review of approximately 20 published papers on HIV\/COVID-19 coinfection. [1] In the last few weeks another eight papers have been published, from the US, China, and South Africa. [2, …<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[282,278],"tags":[],"class_list":["post-38257","post","type-post","status-publish","format-standard","hentry","category-covid-19-hiv-and-covid-19-coinfection","category-covid-19"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/38257","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=38257"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/38257\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=38257"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=38257"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=38257"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}