Case fatality rate and viral aetiologies of acute respiratory tract infections in HIV positive and negative people in Africa: The VARIAFRICA-HIV systematic review and meta-analysis

Kenmoe, Sébastien; Bigna, Jean Joël; Modiyingi, Abdou Fatawou; Ndangang, Marie S.; Ngoupo, Paul Alain; Simo, Fredy Brice N.; Tchatchouang, Serges; Temfack, Elvis; Njouom, Richard

doi:10.1016/j.jcv.2019.06.006

Cited by 11 publications

(10 citation statements)

References 62 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…3 There is mixed evidence on the contribution of HIV to previous respiratory virus epidemics. HIV has been asso ciated with a higher risk of severe outcomes from respir atory infections, including seasonal influenza, 4,5 and people living with HIV at any stage of infection are con sidered a clinical risk group in seasonal influenza vaccin ation guidance in the UK. 6 However, the contribution of HIV infection to outcomes during the 2009 H1N1 influ enza pandemic was unclear, with no substantive evidence that HIV-infected individuals were at increased risk of being infected or had worse outcomes, unless at an adv anced stage of immunosuppression.…”

Section: Introductionmentioning

confidence: 99%

HIV infection and COVID-19 death: a population-based cohort analysis of UK primary care data and linked national death registrations within the OpenSAFELY platform

et al. 2021

View full text Add to dashboard Cite

Background Whether HIV infection is associated with risk of death due to COVID-19 is unclear. We aimed to investigate this association in a large-scale population-based study in England. MethodsWe did a retrospective cohort study. Working on behalf of NHS England, we used the OpenSAFELY platform to analyse routinely collected electronic primary care data linked to national death registrations. We included all adults (aged ≥18 years) alive and in follow-up on Feb 1, 2020, and with at least 1 year of continuous registration with a general practitioner before this date. People with a primary care record for HIV infection were compared with people without HIV. The outcome was COVID-19 death, defined as the presence of International Classification of Diseases 10 codes U07.1 or U07.2 anywhere on the death certificate. Cox regression models were used to estimate the association between HIV infection and COVID-19 death; they were initially adjusted for age and sex, then we added adjustment for index of multiple deprivation and ethnicity, and then for a broad range of comorbidities. Interaction terms were added to assess effect modification by age, sex, ethnicity, comorbidities, and calendar time.Results 17 282 905 adults were included, of whom 27 480 (0•16%) had HIV recorded. People living with HIV were more likely to be male, of Black ethnicity, and from a more deprived geographical area than the general population. 14 882 COVID-19 deaths occurred during the study period, with 25 among people with HIV. People living with HIV had higher risk of COVID-19 death than those without HIV after adjusting for age and sex: hazard ratio (HR) 2•90 (95% CI 1•96-4•30; p<0•0001). The association was attenuated, but risk remained high, after adjustment for deprivation, ethnicity, smoking and obesity: adjusted HR 2•59 (95% CI 1•74-3•84; p<0•0001). There was some evidence that the association was larger among people of Black ethnicity: HR 4•31 (95% CI 2•42-7•65) versus 1•84 (1•03-3•26) in non-Black individuals (p-interaction=0•044).Interpretation People with HIV in the UK seem to be at increased risk of COVID-19 mortality. Targeted policies should be considered to address this raised risk as the pandemic response evolves.

show abstract

Section: Introductionmentioning

confidence: 99%

HIV infection and COVID-19 death: a population-based cohort analysis of UK primary care data and linked national death registrations within the OpenSAFELY platform

et al. 2021

View full text Add to dashboard Cite

show abstract

“…3 There is mixed evidence on the importance of HIV to previous respiratory virus epidemics. HIV has been associated with a higher risk of severe outcomes from respiratory infections including seasonal influenza, 4,5 and people living with HIV at any stage of infection are considered a clinical risk group in seasonal influenza vaccination guidance in the UK. 6 But the importance of HIV infection to outcomes from 2009 H1N1 pandemic influenza was unclear, with no substantive evidence that HIV-infected individuals were at higher risk of being infected or experience poor outcomes, unless at an advanced stage of immunosuppression.…”

Section: Introductionmentioning

confidence: 99%

HIV infection and COVID-19 death: population-based cohort analysis of UK primary care data and linked national death registrations within the OpenSAFELY platform

Bhaskaran

Rentsch

MacKenna

et al. 2020

Preprint

119

152

View full text Add to dashboard Cite

Background: It is unclear whether HIV infection is associated with risk of COVID-19 death. We aimed to investigate this in a large-scale population-based study in England. Methods: Working on behalf of NHS England, we used the OpenSAFELY platform to analyse routinely collected electronic primary care data linked to national death registrations. People with a primary care record for HIV infection were compared to people without HIV. COVID-19 death was defined by ICD-10 codes U07.1 or U07.2 anywhere on the death certificate. Cox regression models were used to estimate the association between HIV infection and COVID-19 death, initially adjusted for age and sex, then adding adjustment for index of multiple deprivation and ethnicity, and finally for a broad range of comorbidities. Interaction terms were added to assess effect modification by age, sex, ethnicity, comorbidities and calendar time. Results: 17.3 million adults were included, of whom 27,480 (0.16%) had HIV recorded. People living with HIV were more likely to be male, of black ethnicity, and from a more deprived geographical area than the general population. There were 14,882 COVID-19 deaths during the study period, with 25 among people with HIV. People living with HIV had nearly three-fold higher risk of COVID-19 death than those without HIV after adjusting for age and sex (HR=2.90, 95% CI 1.96-4.30). The association was attenuated but risk remained substantially raised, after adjustment for deprivation and ethnicity (adjusted HR=2.52, 1.70-3.73) and further adjustment for comorbidities (HR=2.30, 1.55-3.41). There was some evidence that the association was larger among people of black ethnicity (HR = 3.80, 2.15-6.74, compared to 1.64, 0.92-2.90 in non-black individuals, p-interaction=0.045) Interpretation: HIV infection was associated with a markedly raised risk of COVID-19 death in a country with high levels of antiretroviral therapy coverage and viral suppression; the association was larger in people of black ethnicity.

show abstract

“…A study in a Swiss cohort of HIV-infected patients, in which bronchoalveolar wash samples were tested for respiratory viruses, described coronaviruses and influenza A viruses as the most common 7 . On the other hand, reviews assessing the rate of fatality due to acute respiratory infections among persons with HIV, have reported an increased risk in this group of people compared to those without such comorbidity, although without a difference in the viral etiology of the respiratory infection 8 . Additionally, from the follow-up results of previous epidemics for Acute Severe Respiratory Syndrome (SARS), we know that persons with HIV were not the worst prognosis 9 and that one of the drugs used for their treatment, ritonavir-enhanced lopinavir protease inhibitor (LPV/r) in combination with ribavirin, could help decrease the incidence of failure and death in this scenario 10 .…”

Section: In Patients With Hiv-1 or Hiv-2 What Has Been The Epidemiolmentioning

confidence: 94%

“…Al respecto, un estudio realizado en una cohorte suiza de pacientes infectados por VIH, en la cual a partir de muestras de lavado broncoalveolar se realizaron pruebas para detectar virus respiratorios, describió como los más comunes los coronavirus y los virus Influenza A 7 . Por otro lado, revisiones realizadas para valorar la tasa de fatalidad por infecciones respiratorias agudas entre personas viviendo con VIH, han reportado un mayor riesgo en este grupo de personas comparado con aquellos sin dicha comorbilidad, aunque sin una diferencia en cuanto a la etiología viral de la infección respiratoria 8 . Adicionalmente, de los resultados de seguimiento de epidemias previas por el síndrome agudo respiratorio severo (SARS por sus siglas en inglés), conocemos que las personas viviendo con VIH no fueron las que peor pronóstico tuvieron 9 y que uno de los fármacos utilizados para su tratamiento, el inhibidor de la proteasa Lopinavir potenciado con ritonavir (LPV/r) en combinación con Ribavirina, podría ayudar a disminuir la incidencia de falla ventilatoria y muerte en este escenario 10 .…”

Section: En Pacientes Infectados Por Vih-1 O Vih-2 ¿Cuál Ha Sido La unclassified

COVID-19 and HIV

2020

View full text Add to dashboard Cite

Throughout the COVID-19 pandemic, the main risk factors associated with the progression to severe disease or death have been typically advanced age, diabetes mellitus, obesity, high blood pressure, heart disease, and chronic pneumopathy. Because of their immunosuppression status, persons with HIV were also expected to have a higher susceptibility to infection or a poor clinical evolution. So far, this has not been confirmed to happen, giving way to hypotheses about the role of immunosuppression or the use of antiretrovirals, which could explain this paradox. In this article we present the existing data on the epidemiology and characteristics of HIV-COVID-19 co-infection, discuss the available evidence on the possible factors involved in the evolution of individuals affected by both viruses, analyze other determinants that may negatively affect persons with HIV during the pandemic, and present recommendations for the prevention and care of COVID-19 infection in the context of HIV.

show abstract

Case fatality rate and viral aetiologies of acute respiratory tract infections in HIV positive and negative people in Africa: The VARIAFRICA-HIV systematic review and meta-analysis

Cited by 11 publications

References 62 publications

HIV infection and COVID-19 death: a population-based cohort analysis of UK primary care data and linked national death registrations within the OpenSAFELY platform

HIV infection and COVID-19 death: a population-based cohort analysis of UK primary care data and linked national death registrations within the OpenSAFELY platform

HIV infection and COVID-19 death: population-based cohort analysis of UK primary care data and linked national death registrations within the OpenSAFELY platform

COVID-19 and HIV

Contact Info

Product

Resources

About