Characterization of people living with HIV in a Montreal-based tertiary care center with COVID-19 during the first wave of the pandemic

Fehr, Derek; Lebouché, Bertrand; Ruppenthal, Luciana; Brownc, Melodie; Obasc, Nancy; Bourbonnière, Emilie; Girouard, Josée; Massicotte, Angie; Jenabian, Mohammad-Ali; Almomen, Abdul-Aziz; Frenette, Charles; Pokomandy, Alexandra de; Cox, Joseph; Giannakis, Andreas; Cheng, Matthew P.; Kronfli, Nadine; Tsoukas, Christos; Zahedi, Navid; Szabo, Jason; Dehghani, Kianoush; Brouillette, Marie‐Josée; Falutz, Julian; Turner, Howard B.; Hamel, Alexandra; Duchesneau, Claire; Lanthier-Brun, Jasmine; Klein, Marina B.; Routy, Jean‐Pierre; Costiniuk, Cecilia T.

doi:10.1080/09540121.2021.1904500

Cited by 8 publications

(3 citation statements)

References 23 publications

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“…Despite differences among published studies, PLWH seems to be a high-risk group for COVID-19 negative clinical outcomes and higher hospitalization and mortality rates [ 31 , 32 , 33 , 34 ]. This issue could be the consequence of both poor immune responses to SARS-CoV-2 natural infection [ 35 ] and to the contemporary presence of higher rates of chronic comorbidities and low socioeconomic status [ 36 ]. These findings joined with the observation that HIV infection could negatively affect the serological response to other viral agents, such as influenza [ 37 ], lead us to evaluate the effectiveness of the COVID-19 vaccine in this group of people.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of COVID-19 Vaccination in People Living with HIV: A Public Health Fundamental Tool for the Protection of Patients and the Correct Management of Infection

Facciolà

D’Amato

Calimeri

et al. 2022

Infectious Disease Reports

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HIV/AIDS is considered a risk factor for increased mortality due to COVID-19. For this reason, it is essential to include this population in vaccination campaigns. Studies found that antibodies are lower in HIV+ patients than in healthy individuals. The aim of this study was to assess the immune response in a cohort of people living with HIV/AIDS (PLWH) vaccinated with COVID-19 vaccination in order to evaluate the role played by the HIV infection in the efficacy of this vaccine. We carried out a cross-sectional study in the period April-September 2021, involving a cohort of PLWH and a cohort of HIV-uninfected people as the control group. The efficacy of vaccination was high in both groups despite a slight and not significant difference between them. However, important differences were found according to the intensity of the immune response. Specifically, while in the HIV+ group almost a quarter of people had a low response, it is important to remark that the control group had only a high or intermediate response after vaccination. Our results suggest the high efficacy of the mRNA COVID-19 vaccine in PLWH and the importance to vaccinate against COVID-19 in these patients in order to increase their protection.

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Section: Discussionmentioning

confidence: 99%

Efficacy of COVID-19 Vaccination in People Living with HIV: A Public Health Fundamental Tool for the Protection of Patients and the Correct Management of Infection

Facciolà

D’Amato

Calimeri

et al. 2022

Infectious Disease Reports

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“…Furthermore, they found that the risk of death in PLWH with SARS-CoV-2 infection was 80% greater than in HIV negative patients ( 244 ). However, the relationship between HIV and SARS-CoV-2 infection is challenging to decorticate due to many confounding factors, including multiple vulnerabilities and more often belonging to groups disproportionately affected by the pandemic than people without HIV infection ( 245 ).…”

Section: Interplay Between Chronic Inflammation and Viral Persistence Within The Lungsmentioning

confidence: 99%

Pulmonary Immune Dysregulation and Viral Persistence During HIV Infection

2022

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Despite the success of antiretroviral therapy (ART), people living with HIV continue to suffer from high burdens of respiratory infections, lung cancers and chronic lung disease at a higher rate than the general population. The lung mucosa, a previously neglected HIV reservoir site, is of particular importance in this phenomenon. Because ART does not eliminate the virus, residual levels of HIV that remain in deep tissues lead to chronic immune activation and pulmonary inflammatory pathologies. In turn, continuous pulmonary and systemic inflammation cause immune cell exhaustion and pulmonary immune dysregulation, creating a pro-inflammatory environment ideal for HIV reservoir persistence. Moreover, smoking, gut and lung dysbiosis and co-infections further fuel the vicious cycle of residual viral replication which, in turn, contributes to inflammation and immune cell proliferation, further maintaining the HIV reservoir. Herein, we discuss the recent evidence supporting the notion that the lungs serve as an HIV viral reservoir. We will explore how smoking, changes in the microbiome, and common co-infections seen in PLWH contribute to HIV persistence, pulmonary immune dysregulation, and high rates of infectious and non-infectious lung disease among these individuals.

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“…During the COVID-19 pandemic, people with HIV (PWH) had twice the risk of hospitalization compared to HIV-negative individuals [2], and large studies showed up to a threefold increased risk of COVID-19-related mortality in PWH [3][4][5][6][7]. The vulnerability of PWH to severe COVID-19 outcomes stems from a combination of risk factors including high rates of smoking, multimorbidity [8] and social determinants of health [9,10]. Importantly, the suboptimal immunogenicity to many common vaccines in PWH is well recognized and may be attributed, in part, to ongoing B cell dysfunction and ongoing immune activation, resulting in inappropriate responses to stimuli [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Correlates of Breakthrough SARS-CoV-2 Infections in People with HIV: Results from the CIHR CTN 328 Study

Costiniuk,

Lee,

Singer

et al. 2024

Vaccines

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COVID-19 breakthrough infection (BTI) can occur despite vaccination. Using a multi-centre, prospective, observational Canadian cohort of people with HIV (PWH) receiving ≥2 COVID-19 vaccines, we compared the SARS-CoV-2 spike (S) and receptor-binding domain (RBD)-specific IgG levels 3 and 6 months post second dose, as well as 1 month post third dose, in PWH with and without BTI. BTI was defined as positivity based on self-report measures (data up to last study visit) or IgG data (up to 1 month post dose 3). The self-report measures were based on their symptoms and either a positive PCR or rapid antigen test. The analysis was restricted to persons without previous COVID-19 infection. Persons without BTI remained COVID-19-naïve until ≥3 months following the third dose. Of 289 participants, 92 developed BTI (31.5 infections per 100 person-years). The median days between last vaccination and BTI was 128 (IQR 67, 176), with the most cases occurring between the third and fourth dose (n = 59), corresponding to the Omicron wave. In analyses adjusted for age, sex, race, multimorbidity, hypertension, chronic kidney disease, diabetes and obesity, a lower IgG S/RBD (log10 BAU/mL) at 1 month post dose 3 was significantly associated with BTI, suggesting that a lower IgG level at this time point may predict BTI in this cohort of PWH.

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Characterization of people living with HIV in a Montreal-based tertiary care center with COVID-19 during the first wave of the pandemic

Cited by 8 publications

References 23 publications

Efficacy of COVID-19 Vaccination in People Living with HIV: A Public Health Fundamental Tool for the Protection of Patients and the Correct Management of Infection

Efficacy of COVID-19 Vaccination in People Living with HIV: A Public Health Fundamental Tool for the Protection of Patients and the Correct Management of Infection

Pulmonary Immune Dysregulation and Viral Persistence During HIV Infection

Correlates of Breakthrough SARS-CoV-2 Infections in People with HIV: Results from the CIHR CTN 328 Study

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