SARS-CoV-2 Testing and Positivity Among Persons With and Without HIV in 6 US Cohorts

Park, Lesley S.; McGinnis, Kathleen A.; Gordon, Kirsha S.; Justice, Amy C.; Leyden, Wendy A.; Silverberg, Michael J.; Skarbinski, Jacek; Jefferson, Celeena R.; Horberg, Michael A.; Certa, Julia M.; Napravnik, Sonia; Edwards, Jessie K.; Westreich, Daniel; Bastarache, Lisa; Gangireddy, Srushti; Benning, Lorie; D’Souza, Gypsyamber; Williams, Carolyn; Althoff, Keri N.

doi:10.1097/qai.0000000000002943

Cited by 14 publications

(10 citation statements)

References 11 publications

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“…Among United States veterans during the first wave of the pandemic, Park et al [23] reported that 2346 PWH had a higher probability of being tested for SARS-CoV-2 than 4473 HIV-negative individual of comparable characteristics [odds ratio (OR) 1.36; 95% confidence interval (CI): 1.29–1.43). A similar finding was reported by the Corona-Infectious-Virus Epidemiology Team (CIVET) when comparing PWH (from five clinical cohorts within health systems and one interval cohort) with HIV-negative individuals from several United States populations [24].…”

Section: Are People With Hiv At Higher Risk Of Sars-cov-2 Testing Tha...supporting

confidence: 80%

SARS-CoV-2 infection and coronavirus disease 2019 severity in persons with HIV on antiretroviral treatment

Amo¹,

Polo²,

Moreno

et al. 2021

Aids

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The relative susceptibility of people with HIV (PWH) to Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is debated. Numerous studies have been published with apparently contradictory findings, but comparisons are difficult because they have been conducted in populations with different characteristics (e.g. age, prevalence comorbidities) and have used different comparison groups (e.g. HIVnegative cohorts, coronavirus disease 2019 (COVID-19) hospitalized patients, general population), and because of challenges to measure the most important confounders. Here, we review the evidence regarding risk and severity of SARS-CoV-2 infection in PWH compared with persons without HIV. Publications originate largely from highincome settings where the majority of the PWH are on antiretroviral therapy (ART). Despite early evidence supporting higher frequency of SARS-CoV-2 testing in PWH on ART, HIV infection is not associated with SARS-CoV-2 infection, once confounding by socioeconomic characteristic is taken into account. Most publications identify increased COVID-19 severity in PWH compared with people without HIV from the general population or compared with COVID-19 hospitalized patients. The only study with an adequate comparison group to reduce confounding, has not identified differences in COVID-19 disease severity by HIV. Publications consistently identify that COVID-19 severity in PWH is not homogeneous and increases with age and baseline comorbidities. As PWH have a higher prevalence of comorbidities than people without HIV, examining their respective contribution to poor health outcomes is not straight forward as comorbidities could mediate the effect of HIV on COVID-19 outcomes.

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Section: Are People With Hiv At Higher Risk Of Sars-cov-2 Testing Tha...supporting

confidence: 80%

SARS-CoV-2 infection and coronavirus disease 2019 severity in persons with HIV on antiretroviral treatment

Amo¹,

Polo²,

Moreno

et al. 2021

Aids

View full text Add to dashboard Cite

show abstract

“…This observation is in line with previous studies from high-income settings, but substantial differences between populations with different demographic and socioeconomic distributions might occur [5]. HIV infection was not associated with COVID-19 hospitalization, and a relevant association between HIV infection and ICU admission or 30-day all-cause mortality could not Earlier studies have reported that older and frailer PLH with lower CD4+ counts and higher levels of HIV-viremia have a higher risk of severe COVID-19 [1,7]. Herein, among PLH with COVID-19, hospitalized patients were older, had more comorbidities, lower CD4+ counts, and more often were on protease inhibitors.…”

supporting

confidence: 90%

“…Previous reports on the risk of severe outcomes in COVID‐19 in PLH are conflicting, with different study designs and comparison groups precluding direct comparisons [ 6 ]. Earlier studies have reported that older and frailer PLH with lower CD4+ counts and higher levels of HIV‐viremia have a higher risk of severe COVID‐19 [ 1 , 7 ]. Herein, among PLH with COVID‐19, hospitalized patients were older, had more comorbidities, lower CD4+ counts, and more often were on protease inhibitors.…”

mentioning

confidence: 99%

Incidence and severity of COVID‐19 in adults with and without HIV diagnosis

et al. 2022

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“…An extended review is beyond the scope of this document, but several key points should be considered . Recent studies indicate that people with HIV are not at increased risk of acquisition of SARS-CoV-2 compared with people without HIV after controlling for underlying immunosuppression, viral suppression while receiving ART, and comorbidities . Data are conflicting and influenced by regional heterogeneity about the independent contribution of HIV to higher risk of severe disease and mortality due to COVID-19 .…”

Section: Substance Use In Persons At Risk For and With Hivmentioning

confidence: 99%

Antiretroviral Drugs for Treatment and Prevention of HIV Infection in Adults

Gandhi

Bedimo

Hoy

et al. 2023

JAMA

313

148

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ImportanceRecent advances in treatment and prevention of HIV warrant updated recommendations to guide optimal practice.ObjectiveBased on a critical evaluation of new data, to provide clinicians with recommendations on use of antiretroviral drugs for the treatment and prevention of HIV, laboratory monitoring, care of people aging with HIV, substance use disorder and HIV, and new challenges in people with HIV, including COVID-19 and monkeypox virus infection.Evidence ReviewA panel of volunteer expert physician scientists were appointed to update the 2020 consensus recommendations. Relevant evidence in the literature (PubMed and Embase searches, which initially yielded 7891 unique citations, of which 834 were considered relevant) and studies presented at peer-reviewed scientific conferences between January 2020 and October 2022 were considered.FindingsInitiation of antiretroviral therapy (ART) is recommended as soon as possible after diagnosis of HIV. Barriers to care should be addressed, including ensuring access to ART and adherence support. Integrase strand transfer inhibitor–containing regimens remain the mainstay of initial therapy. For people who have achieved viral suppression with a daily oral regimen, long-acting injectable therapy with cabotegravir plus rilpivirine given as infrequently as every 2 months is now an option. Weight gain and metabolic complications have been linked to certain antiretroviral medications; novel strategies to ameliorate these complications are needed. Management of comorbidities throughout the life span is increasingly important, because people with HIV are living longer and confronting the health challenges of aging. In addition, management of substance use disorder in people with HIV requires an evidence-based, integrated approach. Options for preexposure prophylaxis include oral medications (tenofovir disoproxil fumarate or tenofovir alafenamide plus emtricitabine) and, for the first time, a long-acting injectable agent, cabotegravir. Recent global health emergencies, like the SARS-CoV-2 pandemic and monkeypox virus outbreak, continue to have a major effect on people with HIV and the delivery of services. To address these and other challenges, an equity-based approach is essential.Conclusions and RelevanceAdvances in treatment and prevention of HIV continue to improve outcomes, but challenges and opportunities remain.

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SARS-CoV-2 Testing and Positivity Among Persons With and Without HIV in 6 US Cohorts

Abstract: Supplemental Digital Content is Available in the Text.

Cited by 14 publications

References 11 publications

SARS-CoV-2 infection and coronavirus disease 2019 severity in persons with HIV on antiretroviral treatment

SARS-CoV-2 infection and coronavirus disease 2019 severity in persons with HIV on antiretroviral treatment

Incidence and severity of COVID‐19 in adults with and without HIV diagnosis

Antiretroviral Drugs for Treatment and Prevention of HIV Infection in Adults

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