Infectious Disease

People with HIV had fewer – but more severe – SARS-CoV-2 infections than their peers

Source / information

Published by:

Disclosure:
Spinelli reports that he received funding from the NIH during the study. In the study you will find all relevant financial information from all other authors.

ADD SUBJECT TO EMAIL ALARMS

Receive an email when new articles are published

Please enter your email address to receive an email when new articles are published . “data-action =” subscribe “> subscribe

We could not process your request. Please try again later. If you continue to have this problem, please contact customerservice@slackinc.com.

Back to Healio

Researchers in San Francisco found that people with HIV had fewer SARS-CoV-2 infections but had more cases of severe COVID-19 than people without HIV.

Matthew A. Spinelli, MD, MAS, An assistant professor of medicine at the University of California at San Francisco told Healio that a lower serological response in people with HIV could lead to less protection from re-infection or protection over time, although the study wasn’t long enough was to determine this with certainty.

SARS-COV-2 seroprevalence

Source: Spinelli MA, et al. Lancet HIV. 2021; doi: 10.1016 / S2352-3018 (21) 00072-2.

In March, the NIH updated its preliminary guidelines to say people with HIV should be considered a high risk group and prioritized for COVID-19 vaccination. Previous studies have shown that HIV increases the risk of death or worse outcomes from COVID-19, while others have found it doesn’t affect outcomes or the risk of hospitalization for the disease.

In the current study, Spinelli and colleagues said that people with HIV “were likely to have fewer SARS-CoV-2 infections due to greater caution and protection, which in turn was likely due to a higher perceived vulnerability and experience with the HIV epidemic was due, or both. “

Matthew A. Spinelli

“Although the data is mixed, people with HIV, especially those with lower CD4 levels, are likely to be at slightly higher risk for severe COVID-19,” Spinelli said. “Vaccination is an important step in protecting against severe COVID-19.”

Spinelli and colleagues conducted a coordinated, case-control, observational study of people with HIV who were subjected to laboratory tests at the San Francisco General Hospital. They collected 1,138 serum samples from 955 people with HIV and 1,118 samples from 1,062 people without HIV between August 1 and October 31, 2021.

The researchers then collected the samples from people with HIV and age matched them to randomly selected adults without HIV. They compared SARS-CoV-2 seroprevalence by HIV status and rated severe COVID-19 in participants with previous SARS-CoV-2 infections.

They found that the SARS-CoV-2 seroprevalence in people with HIV was 3.7% (95% CI, 2.4-5) and in the HIV-negative cohort 7.4% (95% CI, 5, 7-9.2) was (adjusted OR = 0.5; 95)% CI, 0.3-0.83). Of the 31 people with HIV and 70 HIV-negative participants who showed evidence of previous SARS-CoV-2 infection, the chance of severe COVID-19 in the HIV cohort was 5.52 times (95% CI, 1.01-64.48) higher.

Adjusted for the time since the PCR-confirmed infection, the SARS-CoV-2 immunoglobulin concentrations were lower (-53% percent change; 95% CI, -4 to -76) and the pseudovirus antibody titers were lower (-67% percent change; 95)% CI, -25 to -86) in people with HIV compared to patients without HIV.

Spinelli said it is important to recruit a variety of people with HIV, including those who are not virologically suppressed or who have low CD4 counts, which will allow “more intensive sampling” when studying T-cell responses.

“It will be very important to repeat this study after SARS-CoV-2 vaccination because vaccination can potentially raise antibody levels so high, even in people with previous natural infection, that potential differences may not be clinically significant,” said Spinelli.

ADD SUBJECT TO EMAIL ALARMS

Receive an email when new articles are published

Please enter your email address to receive an email when new articles are published . “data-action =” subscribe “> subscribe

We could not process your request. Please try again later. If you continue to have this problem, please contact customerservice@slackinc.com.

Back to Healio

COVID-19 Resource Center

COVID-19 Resource Center

Related Articles