Risk of SARS-CoV-2 Infection Among People Living With HIV in Wuhan, China

Background In the era of the COVID-19 pandemic, people living with HIV (PLWH) face more challenges. However, it is unclear if PLWH is more susceptible to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection than HIV-negative individuals. This study aimed to explore the prevalence of the SARS-CoV-2 infection and the associated risk factors among PLWH. Methods From 1 to 30 May 2020, we conducted a cross-sectional survey that enrolled 857 PLWH and 1,048 HIV-negative individuals from the Wuchang district in Wuhan, China. Our data analysis compared the rate of the SARS-CoV-2 infection among PLWH and HIV-negative participants, and the proportions of symptomatic patients and asymptomatic infectors between the two groups. We also assessed the risk factors associated with the SARS-CoV-2 infection among PLWH. Results Overall, 14/857 (1.6%) PLWH and 68/1,048 (6.5%) HIV-negative participants were infected with SARS-CoV-2. Among the SARS-CoV-2-infected PLWH participants, 6/14 (42.8%) were symptomatic patients, 4/14 (28.6%) were SARS-CoV-2 nucleic acid-positive asymptomatic infectors, and 4/14 (28.6%) were serology-positive asymptomatic infectors. Among the infected HIV-negative participants, 5/68 (7.4%) patients were symptomatic and 63/68 (92.6%) were serology-positive asymptomatic infectors. The rate of the SARS-CoV-2 infection was lower among the PLWH than in the HIV-negative group (1.96% vs. 5.74%, p = 0.001) and the rate of morbidity among the symptomatic patients was similar between the two groups (p = 0.107). However, there were more serology-positive asymptomatic infectors among the infected HIV-negative participants than among the infected PLWH (0.54% vs. 5.46%, p = 0.001). Furthermore, being 50 years or older (aOR = 4.50, 95% CI: 1.34–15.13, p = 0.015) and having opportunistic infections (aOR = 9.59, 95% CI: 1.54–59.92, p = 0.016) were associated with an increased risk of SARS-CoV-2 infection among PLWH. Conclusions PLWH has more varied forms of the SARS-CoV-2 infection than the HIV-negative population and should, therefore, undertake routine screening to avoid late diagnosis. Also, older age (≥50 years) and having opportunistic infections increase the risks of SARS-CoV-2 infection among PLWH.

[1]  K. Liang,et al.  People living with HIV easily lose their immune response to SARS-CoV-2: result from a cohort of COVID-19 cases in Wuhan, China , 2021, BMC Infectious Diseases.

[2]  M. Gandhi,et al.  The interplay between HIV and COVID-19: summary of the data and responses to date , 2020, Current opinion in HIV and AIDS.

[3]  Yunbao Pan,et al.  Seroprevalence of SARS-CoV-2 immunoglobulin antibodies in Wuhan, China: part of the city-wide massive testing campaign , 2020, Clinical Microbiology and Infection.

[4]  Sheng Wei,et al.  Epidemiological, virological and serological features of COVID-19 cases in people living with HIV in Wuhan City: A population-based cohort study , 2020, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[5]  Felipe García,et al.  Clinical characteristics, risk factors, and incidence of symptomatic coronavirus disease 2019 in a large cohort of adults living with HIV: a single-center, prospective observational study , 2020, AIDS.

[6]  E. Eryuksel,et al.  Tuberculosis and COVID-19: An overlapping situation during pandemic. , 2020, Journal of infection in developing countries.

[7]  Menghua Wu,et al.  Case report: one case of coronavirus disease 2019 (COVID-19) in a patient co-infected by HIV with a normal CD4+ T cell count , 2020, AIDS Research and Therapy.

[8]  Janakiram Marimuthu,et al.  HIV and SARS CoV‐2 coinfection: A retrospective, record‐based, case series from South India , 2020, Journal of medical virology.

[9]  B. Meyer,et al.  SARS-CoV-2 seroprevalence in COVID-19 hotspots , 2020, The Lancet.

[10]  K. Liang,et al.  Patterns of HIV and SARS‐CoV‐2 co‐infection in Wuhan, China , 2020, Journal of the International AIDS Society.

[11]  X. Tang,et al.  Clinical and immunological assessment of asymptomatic SARS-CoV-2 infections , 2020, Nature Medicine.

[12]  Noga Shalev,et al.  Clinical Characteristics and Outcomes in People Living With Human Immunodeficiency Virus Hospitalized for Coronavirus Disease 2019 , 2020, Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America.

[13]  R. López-Vélez,et al.  Description of COVID-19 in HIV-infected individuals: a single-centre, prospective cohort , 2020, The Lancet HIV.

[14]  N. Shabarek,et al.  Clinical features and outcome of HIV/SARS‐CoV‐2 coinfected patients in The Bronx, New York city , 2020, Journal of medical virology.

[15]  Kurt M Kunz.  A Trial of Lopinavir-Ritonavir in Covid-19. , 2020, The New England journal of medicine.

[16]  M. Bickel,et al.  COVID-19 in people living with human immunodeficiency virus: a case series of 33 patients , 2020, Infection.

[17]  Maomao Wang,et al.  One case of coronavirus disease 2019 (COVID-19) in a patient co-infected by HIV with a low CD4+ T-cell count , 2020, International Journal of Infectious Diseases.

[18]  Antonio Romanelli,et al.  Could HIV infection alter the clinical course of SARS‐CoV‐2 infection? When less is better , 2020, Journal of medical virology.

[19]  P. Adepoju,et al.  Tuberculosis and HIV responses threatened by COVID-19 , 2020, The Lancet HIV.

[20]  Bonggun Shin,et al.  Predicting commercially available antiviral drugs that may act on the novel coronavirus (SARS-CoV-2) through a drug-target interaction deep learning model , 2020, Computational and Structural Biotechnology Journal.

[21]  K. Liang,et al.  A Survey for COVID-19 Among HIV/AIDS Patients in Two Districts of Wuhan, China , 2020 .

[22]  Zunyou Wu,et al.  Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. , 2020, JAMA.

[23]  Guo-Wei Wei,et al.  Machine intelligence design of 2019-nCoV drugs , 2020, bioRxiv.

[24]  Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV , 2020 .

[25]  Tara Giacchino,et al.  Hysterectomy and Adenextomy via transvaginal natural orifice transluminal endoscopic surgery (vNOTES): A UK perspective with a case series of 33 patients. , 2019, European journal of obstetrics, gynecology, and reproductive biology.

[26]  S. Seedat,et al.  HIV , 2018, The Lancet.

[27]  S. Pallikkuth,et al.  T Follicular Helper Cells and B Cell Dysfunction in Aging and HIV-1 Infection , 2017, Front. Immunol..

[28]  G. Bartlett,et al.  Incidence and Prevalence of Opportunistic and Other Infections and the Impact of Antiretroviral Therapy Among HIV-infected Children in Low- and Middle-income Countries: A Systematic Review and Meta-analysis , 2016, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[29]  Cheng-Li Lin,et al.  A population-based cohort study. , 2015 .