Immune deficiency is a risk factor for severe COVID-19 in people living with HIV
© 2020 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association..
OBJECTIVES: A prior T cell depletion induced by HIV infection may carry deleterious consequences in the current COVID-19 pandemic. Clinical data on patients co-infected with HIV and SARS-CoV-2 are still scarce.
METHODS: This multicentre cohort study evaluated risk factors for morbidity and mortality of COVID-19 in people living with HIV (PLWH), infected with SARS-CoV-2 in three countries in different clinical settings. COVID-19 was clinically classified as to be mild-to-moderate or severe.
RESULTS: Of 175 patients, 49 (28%) had severe COVID-19 and 7 (4%) patients died. Almost all patients were on antiretroviral therapy (ART) and in 94%, HIV RNA was below 50 copies/mL prior to COVID-19 diagnosis. In the univariate analysis, an age 50 years or older, a CD4+ T cell nadir of < 200/µl, current CD4+ T cells < 350/µl and the presence of at least one comorbidity were significantly associated with severity of COVID-19. No significant association was found for gender, ethnicity, obesity, a detectable HIV RNA, a prior AIDS-defining illness, or tenofovir (which was mainly given as alafenamide) or protease inhibitor use in the current ART. In a multivariate analysis, the only factor associated with risk for severe COVID-19 was a current CD4+ T cell count of < 350/µl (adjusted odds ratio 2.85, 95% confidence interval 1.26-6.44, p=0.01). The only factor associated with mortality was a low CD4 T cell nadir.
CONCLUSIONS: In PLWH, immune deficiency is a possible risk factor for severe COVID-19, even in the setting of virological suppression. There is no evidence for a protective effect of PIs or tenofovir alafenamide.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:22 |
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| Enthalten in: |
HIV medicine - 22(2021), 5 vom: 04. Mai, Seite 372-378 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Hoffmann, Christian [VerfasserIn] |
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| Links: |
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| Themen: |
Antiretroviral therapy |
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| Anmerkungen: |
Date Completed 21.04.2021 Date Revised 21.04.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/hiv.13037 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM319332241 |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2020 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association. | ||
| 520 | |a OBJECTIVES: A prior T cell depletion induced by HIV infection may carry deleterious consequences in the current COVID-19 pandemic. Clinical data on patients co-infected with HIV and SARS-CoV-2 are still scarce | ||
| 520 | |a METHODS: This multicentre cohort study evaluated risk factors for morbidity and mortality of COVID-19 in people living with HIV (PLWH), infected with SARS-CoV-2 in three countries in different clinical settings. COVID-19 was clinically classified as to be mild-to-moderate or severe | ||
| 520 | |a RESULTS: Of 175 patients, 49 (28%) had severe COVID-19 and 7 (4%) patients died. Almost all patients were on antiretroviral therapy (ART) and in 94%, HIV RNA was below 50 copies/mL prior to COVID-19 diagnosis. In the univariate analysis, an age 50 years or older, a CD4+ T cell nadir of < 200/µl, current CD4+ T cells < 350/µl and the presence of at least one comorbidity were significantly associated with severity of COVID-19. No significant association was found for gender, ethnicity, obesity, a detectable HIV RNA, a prior AIDS-defining illness, or tenofovir (which was mainly given as alafenamide) or protease inhibitor use in the current ART. In a multivariate analysis, the only factor associated with risk for severe COVID-19 was a current CD4+ T cell count of < 350/µl (adjusted odds ratio 2.85, 95% confidence interval 1.26-6.44, p=0.01). The only factor associated with mortality was a low CD4 T cell nadir | ||
| 520 | |a CONCLUSIONS: In PLWH, immune deficiency is a possible risk factor for severe COVID-19, even in the setting of virological suppression. There is no evidence for a protective effect of PIs or tenofovir alafenamide | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a HIV infection | |
| 650 | 4 | |a SARS-CoV-2 | |
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| 700 | 1 | |a Härter, Georg |e verfasserin |4 aut | |
| 700 | 1 | |a Vizcarra, Pilar |e verfasserin |4 aut | |
| 700 | 1 | |a Moreno, Ana |e verfasserin |4 aut | |
| 700 | 1 | |a Cattaneo, Dario |e verfasserin |4 aut | |
| 700 | 1 | |a Meraviglia, Paola |e verfasserin |4 aut | |
| 700 | 1 | |a Spinner, Christoph D |e verfasserin |4 aut | |
| 700 | 1 | |a Schabaz, Farhad |e verfasserin |4 aut | |
| 700 | 1 | |a Grunwald, Stephan |e verfasserin |4 aut | |
| 700 | 1 | |a Gervasoni, Cristina |e verfasserin |4 aut | |
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