{"id":39531,"date":"2020-12-09T07:35:06","date_gmt":"2020-12-09T07:35:06","guid":{"rendered":"https:\/\/i-base.info\/htb\/?p=39531"},"modified":"2020-12-10T19:16:27","modified_gmt":"2020-12-10T19:16:27","slug":"recent-studies-on-hiv-and-covid-19-coinfection","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/39531","title":{"rendered":"Recent studies on HIV and COVID-19 coinfection"},"content":{"rendered":"

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

The following papers have been published that include clinical outcomes on HIV positive people who were diagnosed with COVID-19, with brief summaries from the abstract.<\/span><\/strong><\/p>\n

Virologic and immunologic outcomes for HIV patients with coronavirus disease 2019<\/h2>\n

Hu R et al. JAIDS.\u00a0<\/span>doi: 10.1097\/QAI.0000000000002540. (15 October 2020).
\n<\/span>https:\/\/journals.lww.com\/jaids\/Abstract\/9000\/Virologic_and_immunologic_outcomes_for_HIV.96050.aspx<\/a><\/p>\n

Results from 35 HIV positive people showing higher viral load after recovery from COVID-19.<\/p>\n

\u201cTwenty of the 35 co-infected patients were identified as asymptomatic\/mild\/moderate COVID-19 (non-severe group) and 15 were identified as severe\/critical (severe group). The severe and non-severe group had no differences in demographics, HIV baseline status, the intervals between last tests and follow-up tests for CD4 cell count and HIV viral load (all\u00a0<\/span>p<\/span>>0.05). Overall, there was a significantly increased number of co-infected patients with HIV-1 viral load \u226520 copies\/mL after recovery (<\/span>p<\/span>=0.008). The median viral load increased significantly after recovery in severe group (<\/span>p<\/span>=0.034) while no significant change of HIV viral load was observed in non-severe group. Limited change of CD4 cell count was found (all\u00a0<\/span>p<\/span>>0.05).\u201d<\/span><\/i><\/p>\n

AIDS October 2020: Special selection on HIV and COVID-19<\/h2>\n

The following articles are included in the 1 October edition of AIDS. This issue of HTB include links to both editorial comment and clinical studies from this edition.<\/span><\/strong><\/p>\n

Editorial introduction<\/h2>\n
\n

Michael Saag. AIDS. 34(12):1755-1756, October 1, 2020.
\n<\/span>https:\/\/journals.lww.com\/aidsonline\/Fulltext\/2020\/10010\/Special_section__COVID_19_among_people_living_with.6.aspx<\/a><\/p>\n

What one pandemic can teach us in facing another<\/h2>\n<\/div>\n

Wafaa El-Sadr, AIDS. 34(12):1757-1759, October 1, 2020.
\n<\/span>https:\/\/journals.lww.com\/aidsonline\/Fulltext\/2020\/10010\/What_one_pandemic_can_teach_us_in_facing_another.7.aspx<\/a><\/p>\n

Preserving 2 decades of healthcare gains for Africa in the coronavirus disease 2019 era<\/h2>\n

Sonak Pastakia et al. AIDS. 34(12):1761-1763, October 1, 2020.
\n<\/span>https:\/\/journals.lww.com\/aidsonline\/Fulltext\/2020\/10010\/Preserving_2_decades_of_healthcare_gains_for.8.aspx<\/a><\/p>\n

Coronavirus disease 2019 attack rate in HIV-infected patients and in preexposure prophylaxis users<\/h2>\n

Charre, C et al. AIDS. 34(12):1765-1770, October 1, 2020.
\nhttps:\/\/journals.lww.com\/aidsonline\/Fulltext\/2020\/10010\/Coronavirus_disease_2019_attack_rate_in.9.aspx<\/a><\/p>\n

Retrospective database analysis, with very small numbers of HIV positive and PrEP users that reported similar incidence in all groups.<\/span><\/p>\n

\u201cFrom March to April 2020, of 24,860 samples from 19,113 patients (HIV positive 77, PrEP users 27, others 19,009) were assessed for SARS-CoV-2 PCR assay. The positivity rate appeared similar in\u00a0HIV positive patients (15.6%), PrEP users (14.8%) and other patients (19.1%). The crude\/corrected COVID-19\u00a0attack rate\u00a0appeared similar in\u00a0HIV positive patients (0.31\/0.38%) and in PrEP users (0.38\/0.42%), and of the same order as the estimated\u00a0attack rate\u00a0in the general population (0.24%).\u201d<\/i><\/p>\n

HIV infection and COVID-19 risk factors for severe disease<\/h2>\n

Etienne N et al. Research letter, AIDS:<\/span>;34(12):1771-1774.doi: 10.1097\/QAD.0000000000002651. (1 October 2020).
\n<\/span>https:\/\/journals.lww.com\/aidsonline\/Fulltext\/2020\/10010\/HIV_infection_and_COVID_19__risk_factors_for.10.aspx<\/a><\/p>\n

\n

\u201cWe performed an observational prospective monocentric study in patients living with HIV diagnosed with COVID-19. Fifty four HIV positive people developed COVID-19 with respectively 14 severe (25.9%) and 5 critical cases (9.3%). By multivariate analysis, age, male gender, ethnic origin from Sub Saharan Africa, and metabolic disorder, were associated with severe or critical forms of COVID-19. Prior CD4 cell counts did not differ between groups. No protective effect of a particular antiretroviral class was observed.\u201d<\/span><\/i><\/p>\n

Clinical characteristics, risk factors, and incidence of symptomatic\u00a0coronavirus disease 2019\u00a0in a large cohort of adults living with\u00a0HIV<\/h2>\n

Inciarte A et al. AIDS:\u00a0October 1, 2020 – Volume 34 – Issue 12 – p 1775-1780. doi: 10.1097\/QAD.0000000000002643.
\nhttps:\/\/journals.lww.com\/aidsonline\/Fulltext\/2020\/10010\/Clinical_characteristics,_risk_factors,_and.11.aspx<\/a><\/p>\n<\/div>\n

Prospective observational study of 53 HIV positive people diagnosed with COVID-19.<\/span><\/p>\n

\u201c<\/span><\/i>From 1 March 2020 to 10 May 2020, 53 out of 5683 (0.9% confidence interval 0.7\u20131.2%) people living with HIV were diagnosed with COVID-19. Median age was 44 years, CD4 count was 618 cells\/mm3<\/sup>and CD4\/CD8\u00a0was 0.90. All but two individuals were virologically suppressed. Cough (87%) and fever (82%) were the most common symptoms. Twenty-six (49%) were admitted, six (14%) had severe disease, four (8%) required ICU admission, and two (4%) died. Several laboratory markers (lower O2<\/sub>\u00a0saturation and platelets, and higher leukocytes, creatinine, lactate dehydrogenase, C reactive protein, procalcitonin, and ferritin) were associated with COVID-19 severity. No\u00a0HIV or ARV-related factors were associated with COVID-19 diagnosis or severity. Standardised incidence rate ratios of confirmed or confirmed\/probable COVID-19 in HIV positive people were 38% (95%CI: 27 to 52%,\u00a0p<0.0001) and 33% (95% CI: 21 to 50%,\u00a0p<0.0001), respectively relative to the general population.\u201d<\/i><\/p>\n

Disproportionate burden of coronavirus disease 2019 among racial minorities and those in congregate settings among a large cohort of people with HIV<\/h2>\n

Meyerowitz EA et al. AIDS.\u00a034(12):1781-1787, October 1, 2020.
\nhttps:\/\/journals.lww.com\/aidsonline\/Fulltext\/2020\/10010\/Disproportionate_burden_of_coronavirus_disease.12.aspx<\/a><\/p>\n

US report on 26 HIV positive people diagnosed with COVID-19 during March – April 2020 in Massachusetts and impact of non-HIV risk factors and racial disparities.<\/p>\n

\u201cWe describe a cohort of 36 HIV positive people with confirmed COVID-19 and another 11 patients with probable COVID-19. Almost 85% of HIV positive with confirmed COVID-19 had a comorbidity associated with severe disease, including obesity, cardiovascular disease, or hypertension. Approximately 77% of HIV positive with COVID-19 were non-Hispanic Black or Latinx whereas only 40% of the HIV positive people in our clinic were Black or Latinx. Nearly half of HIV positive people with COVID-19 had exposure to congregate settings. In addition to people with confirmed COVID-19, we identified another 11 individuals with probable COVID-19, almost all of whom had negative PCR testing.\u201d<\/span><\/i><\/p>\n

Clinical characteristics, comorbidities and outcomes among persons with HIV hospitalised with coronavirus disease 2019 in Atlanta, Georgia<\/h2>\n

Collins LF et al. AIDS.\u00a034(12):1789-1794, October 1, 2020.
\nhttps:\/\/journals.lww.com\/aidsonline\/Fulltext\/2020\/10010\/Clinical_characteristics,_comorbidities_and.13.aspx<\/a><\/p>\n

US case series of all HIV positive people diagnosed with COVID-19 at three hospitals in Atlanta.<\/p>\n

\u201cOf 530 confirmed COVID-19 cases hospitalised during this period, 20 occurred among PWH (3.8%). The median age was 57 (Q1\u2013Q3, 48\u201362) years, 65% were men, and 85% were non-Hispanic Black. Presenting median symptom duration was 5 (Q1\u2013Q3, 3\u20137) days; cough (90%), fever (65%), malaise (60%) and dyspnea (60%) were most common. On admission, 40% of patients required oxygenation support and 65% had an abnormal chest radiograph. Median length of hospitalisation was 5 days (Q1 to Q3, 4 to 12), 30% required intensive care, 15% required intubation, and 15% died. Median CD4\u00a0cell count prior to admission was 425 (Q1\u2013Q3, 262\u2013815) cells\/mm3<\/sup>and 90% of patients had\u00a0HIV-1 RNA less than 200 copies\/mL. Half of the patients had at least five comorbidities; hypertension (70%), dyslipidemia (60%) and diabetes (45%) were most prevalent. All three patients who died had CD4+<\/sup>\u00a0cell count more than 200,\u00a0HIV\u00a0suppression and each had a total of five comorbidities.”<\/span><\/i><\/p>\n

Comorbidity indices in people with HIV and considerations for coronavirus disease 2019 outcomes<\/h2>\n
\n

Winston A et al. AIDS.\u00a034(12):1795-1800, October 1, 2020.
\nhttps:\/\/journals.lww.com\/aidsonline\/Fulltext\/2020\/10010\/Comorbidity_indices_in_people_with_HIV_and.14.aspx<\/a><\/p>\n<\/div>\n

A cross-sectional study looking for comorbidity indices of COVID-19 among older HIV positive people and a matched HIV negative control group (POPPY study).<\/p>\n

\u201cThe 699 HIV positive and 304\u00a0HIV negative controls were predominantly male (87.5% vs. 64.0%), white (86.3% vs. 90.0%) and had median ages of 57 and 58 years, respectively. Among PWH, the median (IQR) CD4count was 624 (475 to 811) cells\/mm3<\/sup>; 98.7% were on ART. The median (IQR) ECI was 0 (0 to 8) and 0 (\u22123 to 1), Charlson Comorbidity Index was 2 (1 to 5) and 1 (0 to 1) and Comorbidity Burden Index 8.6 (2.2, 16.8) and 5.9 (0.6, 10.8), respectively. While all three indices were significantly higher in PWH than in controls (p<0.001 for each), the magnitude of the differences between the two groups were small to medium, with effect sizes (95%CI) of 0.21 (0.16 to 0.27), 0.38 (0.32 to 0.42) and 0.18 (0.11 to 0.23), respectively.\u201d<\/span><\/i><\/p>\n","protected":false},"excerpt":{"rendered":"

Simon Collins, HIV i-Base The following papers have been published that include clinical outcomes on HIV positive people who were diagnosed with COVID-19, with brief summaries from the abstract. Virologic and immunologic outcomes for HIV patients with coronavirus disease 2019 …<\/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-39531","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\/39531","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=39531"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/39531\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=39531"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=39531"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=39531"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}