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1.
J Med Virol ; 2022 Jan 03.
Article in English | MEDLINE | ID: mdl-34978094

ABSTRACT

The human immunodeficiency virus (HIV), like any other disease, has created great worry in Afghanistan. The country's slew of issues has paved the way for HIV to spread and go unchecked. International groups have banded together to stop the virus's spread since the first case was confirmed in Afghanistan. The cumulative effects of international collaboration have aided in the reduction of cases and improved awareness. Because of their injection use, a large portion of the country's population has been classified as a vulnerable category for HIV infection. Awareness campaigns and international collaboration should be implemented to further limit the spread of HIV.

2.
Clin Infect Dis ; 2022 Jan 18.
Article in English | MEDLINE | ID: mdl-35040928

ABSTRACT

BACKGROUND: Uptake of HIV preexposure prophylaxis (PrEP) has been increasing in the United States since its FDA approval in 2012; however, the COVID-19 pandemic may have affected this trend. Our objective was to assess the impact of the COVID-19 pandemic on PrEP prescriptions in the United States. METHODS: We analyzed data from a national pharmacy database from January 2017 through March 2021 to fit an interrupted time-series model that predicted PrEP prescriptions and new PrEP users had the pandemic not occurred. Observed PrEP prescriptions and new users were compared with those predicted by the model. Main outcomes were weekly numbers of PrEP prescriptions and new PrEP users based on a previously developed algorithm. The impact of the COVID-19 pandemic was quantified by computing rate ratios and percent decreases between the observed and predicted counts during 3/15/2020 - 3/31/2021. RESULTS: In the absence of the pandemic, our model predicted that there would have been 1,058,162 PrEP prescriptions during 3/15/2020 - 3/31/2021. We observed 825,239 PrEP prescriptions, a 22.0% reduction (95% CI: 19.1%-24.8%) after the emergency declaration. The model predicted 167,720 new PrEP users during the same period; we observed 125,793 new PrEP users, a 25.0% reduction (95% CI: 20.9%-28.9%). The COVID-19 impact was greater among younger persons and those with commercial insurance. The impact of the pandemic varied markedly across states. CONCLUSION: The COVID-19 pandemic disrupted an increasing trend in PrEP prescriptions in the United States, highlighting the need for innovative interventions to maintain access to HIV prevention services during similar emergencies.

3.
J Acquir Immune Defic Syndr ; 89(Suppl 1): S1-S2, 2022 02 01.
Article in English | MEDLINE | ID: mdl-35015738

ABSTRACT

ABSTRACT: Our understanding of HIV/AIDS has been reframed during the recent past because the use of novel antiretroviral therapy has enabled clinicians and patients to control the progression of the disease. This supplement provides an overview of the HIV and Aging in the Era of ART and COVID-19, a virtual symposium held on February 8-9, 2021, organized by the Miami Center for AIDS Research along with articles contributed by some of the speakers and members of the organizing committee and presentations by junior investigators.


Subject(s)
Aging/immunology , Anti-HIV Agents/therapeutic use , COVID-19 , Continuity of Patient Care , HIV Infections/drug therapy , Health Services Accessibility , Antiretroviral Therapy, Highly Active/adverse effects , COVID-19/epidemiology , COVID-19/psychology , HIV Infections/immunology , HIV Infections/psychology , Humans , SARS-CoV-2
5.
J Acquir Immune Defic Syndr ; 89(Suppl 1): S10-S14, 2022 02 01.
Article in English | MEDLINE | ID: mdl-35015740

ABSTRACT

BACKGROUND: Owing to ongoing improvements in antiretroviral therapy, people with HIV (PWH) are achieving near-normal lifespans with many surviving into middle and old age. Despite this success, PWH have a higher than expected risk of developing non-AIDS comorbidities, multimorbidity, and functional decline at ages younger than those without HIV. METHODS: As part of the Inter-CFAR (Center for AIDS Research) Symposium, HIV and Aging in the era of Antiretroviral Therapy and COVID-19, we presented a research update from HIV clinical cohorts and specifically described 3 lessons learned from the Centers for AIDS Research Network of Integrated Clinical Systems cohort that are important for HIV and aging research moving forward. RESULTS: Adjudicated outcomes are particularly beneficial for less common comorbidities such as myocardial infarction. Multiple ascertainment approaches increase sensitivity over using diagnoses alone (89% vs. 44%). Adjudication eliminates false-positive events and allows myocardial infarction types to be identified. Comorbidity research has often relied on composite outcomes, such as all cardiovascular diseases, often to increase power. Mechanistic differences across outcomes demonstrate the importance of moving away from many composite outcomes. Timely data are needed to ensure findings are relevant to improve care or outcomes for the population of PWH who are currently aging. CONCLUSIONS: A better understanding of the causes, mechanisms, prevention and treatment of functional decline, comorbidities, and multimorbidities is a crucial research focus as PWH are aging. Clinical cohorts with timely, comprehensive harmonized clinical data and carefully adjudicated outcomes are ideally positioned to improve understanding of these questions.


Subject(s)
Aging , COVID-19 , HIV Infections , Myocardial Infarction , COVID-19/epidemiology , Comorbidity , HIV Infections/drug therapy , HIV Infections/epidemiology , Humans , Myocardial Infarction/epidemiology , SARS-CoV-2
6.
J Acquir Immune Defic Syndr ; 89(Suppl 1): S65-S72, 2022 Feb 01.
Article in English | MEDLINE | ID: mdl-35015747

ABSTRACT

BACKGROUND: Resilience is defined as an individual's positive adaptation to stressors. The COVID-19 pandemic represents a generalized stressor which may affect differently people living with HIV (PLWH). The objective of this study was to characterize resilience in PLWH with particular regarding the identification of frailty-resilience phenotypes, which may differently affect health-related quality of life (HR-QoL). METHODS: This was an observational study of PLWH attending Modena HIV Metabolic Clinic. Frailty was assessed in 2019, before the onset of the COVID-19 pandemic by using 37-Item frailty index ranging from 0 to 1. The frailty index score was categorized as fit (<0.25) or frail (>0.25). In January 2021, PLWH were offered to complete a set of electronic questionnaires including the CD-RISC-25 for resilience and EQ-5D5L and SF-36 for HR-QoL. Resilience was defined as CD-RISC-25 score >75.7 (ranging from 0 to 100). RESULTS: Of 800 PLWH reached by mail, 575 (72%) completed the questionnaires. The median age and HIV duration were 54.5 and 24.3 years, respectively. Impaired resilience was associated with loneliness [odds ratio (OR = 2.39; 1.20 to 4.76, P < 0.001)]. Predictors for EQ-5D5L <89.7% were the phenotypes "frail/nonresilient" [OR = 5.21, 95% confidence interval (CI): 2.62 to 10.33] and "fit/nonresilient" (OR = 5.48, 95% CI: 2.8 to 10.74). Predictors for SF-36 <64.40 were the phenotypes "frail/nonresilient" (OR = 7.43, 95% CI: 2.57 to 21.22) and "fit/nonresilient" (OR = 6.27, 95% CI: 2.17 to 18.16). Both models were corrected for age, sex, HIV duration, and nadir CD4. CONCLUSIONS: Resilience characterizes the well-being of PLWH during the COVID-19 crisis. This construct is complementary to frailty in the identification of clinical phenotypes with different impacts on HR-QoL.


Subject(s)
Aging , COVID-19/psychology , Frail Elderly/psychology , Frailty/psychology , HIV Infections/psychology , Quality of Life/psychology , Resilience, Psychological , Aged , COVID-19/epidemiology , Cross-Sectional Studies , Female , HIV Infections/complications , HIV Infections/drug therapy , Humans , Male , Pandemics , SARS-CoV-2
7.
Molecules ; 27(1)2022 Jan 04.
Article in English | MEDLINE | ID: mdl-35011529

ABSTRACT

When developing drugs against SARS-CoV-2, it is important to consider the characteristics of patients with different co-morbidities. People infected with HIV-1 are a particularly vulnerable group, as they may be at a higher risk than the general population of contracting COVID-19 with clinical complications. For such patients, drugs with a broad spectrum of antiviral activity are of paramount importance. Glycyrrhizinic acid (Glyc) and its derivatives are promising biologically active compounds for the development of such broad-spectrum antiviral agents. In this work, derivatives of Glyc obtained by acylation with nicotinic acid were investigated. The resulting preparation, Glycyvir, is a multi-component mixture containing mainly mono-, di-, tri- and tetranicotinates. The composition of Glycyvir was characterized by HPLC-MS/MS and its toxicity assessed in cell culture. Antiviral activity against three strains of SARS-CoV-2 was tested in vitro on Vero E6 cells by MTT assay. Glycyvir was shown to inhibit SARS-CoV-2 replication in vitro (IC502-8 µM) with an antiviral activity comparable to the control drug Remdesivir. In addition, Glycyvir exhibited marked inhibitory activity against HIV pseudoviruses of subtypes B, A6 and the recombinant form CRF63_02A (IC50 range 3.9-27.5 µM). The time-dependence of Glycyvir inhibitory activity on HIV pseudovirus infection of TZM-bl cells suggested that the compound interfered with virus entry into the target cell. Glycyvir is a promising candidate as an agent with low toxicity and a broad spectrum of antiviral action.


Subject(s)
Antiviral Agents/pharmacology , COVID-19/drug therapy , Glycyrrhizic Acid/chemistry , HIV Infections/drug therapy , HIV-1/drug effects , SARS-CoV-2/drug effects , Virus Replication , Animals , Antiviral Agents/chemical synthesis , COVID-19/virology , Chlorocebus aethiops , HIV Infections/virology , HeLa Cells , Humans , In Vitro Techniques , Vero Cells
8.
Br J Nurs ; 31(1): S23-S25, 2022 01 13.
Article in English | MEDLINE | ID: mdl-35019749
9.
AIDS ; 2022 Jan 06.
Article in English | MEDLINE | ID: mdl-34999608

ABSTRACT

OBJECTIVE: To evaluate the safety and the serological response after two doses of mRNA-based SARS-CoV-2 vaccination in people living with HIV (PLWH). PATIENTS AND METHODS: Participants were evaluated four weeks after the second dose of mRNA-1273 or BNT162b2 vaccine. Tolerability was evaluated with a specific adverse event questionnaire. Patient's sera were analyzed using LIAISON® SARS-CoV-2 TrimericS IgG (DiaSorin). RESULTS: One-hundred PLWH were included, 75% of them men, with a mean age of 44 ±â€Š11 years old, all receiving antiretroviral treatment and mostly with controlled viral loads (98% with HIV RNA <50 copies/mL) and 96% had >200 CD4/µL. All patients seroconverted after vaccination (antibody concentration ≥33.8 BAU/mL). Only 3% of the patients had a low antibody concentration (<520 BAU/mL), whereas a 67% of them had concentrations above the assay's detection range (>2,080 BAU/mL). Fifty-six patients had local or systemic symptoms, being mild arthromyalgia the most common systemic symptom. No severe adverse events were reported. CONCLUSIONS: vaccination with two doses of mRNA-1273 or BNT162b2 is safe in PLWH under effective ART and it leads to a successfully antibodies response.

10.
bioRxiv ; 2022 Jan 11.
Article in English | MEDLINE | ID: mdl-35043114

ABSTRACT

SARS-CoV-2 and HIV-1 are RNA viruses that have killed millions of people worldwide. Understanding the similarities and differences between these two infections is critical for understanding disease progression and for developing effective vaccines and therapies, particularly for 38 million HIV-1 + individuals who are vulnerable to SARS-CoV-2 co-infection. Here, we utilized single-cell transcriptomics to perform a systematic comparison of 94,442 PBMCs from 7 COVID-19 and 9 HIV-1 + patients in an integrated immune atlas, in which 27 different cell types were identified using an accurate consensus single-cell annotation method. While immune cells in both cohorts show shared inflammation and disrupted mitochondrial function, COVID-19 patients exhibit stronger humoral immunity, broader IFN-I signaling, elevated Rho GTPase and mTOR pathway activities, and downregulated mitophagy. Our results elucidate transcriptional signatures associated with COVID-19 and HIV-1 that may reveal insights into fundamental disease biology and potential therapeutic targets to treat these viral infections. Highlights: COVID-19 and HIV-1 + patients show disease-specific inflammatory immune signatures COVID-19 patients show more productive humoral responses than HIV-1 + patients SARS-CoV-2 elicits more enriched IFN-I signaling relative to HIV-IDivergent, impaired metabolic programs distinguish SARS-CoV-2 and HIV-1 infections.

11.
Br J Nurs ; 31(1): S10-S15, 2022 Jan 13.
Article in English | MEDLINE | ID: mdl-35019747

ABSTRACT

The COVID-19 pandemic has created a set of unprecedented challenges for healthcare services and staff. The authors conducted a national online survey of nurses employed to work in HIV services in England, Wales, Scotland, Northern Ireland and the Republic of Ireland to establish how the COVID-19 pandemic has impacted on the professional quality of life of HIV nurses. Professional quality of life was assessed using the ProQOL scale; 132 nurses completed the survey, 99 of whom completed the ProQOL scale. Just over 1 in 3 were redeployed in the first pandemic wave, dropping to 1 in 6 in subsequent waves. In multivariate analysis, redeployment in both waves increased burnout scores by nearly 10 points and decreased compassion satisfaction scores by nearly 5 points, with no effect on secondary traumatic stress scores. A supportive workplace environment will have a key role in supporting the path to recovery.


Subject(s)
Burnout, Professional , COVID-19 , HIV Infections , Burnout, Professional/epidemiology , HIV Infections/epidemiology , Humans , Job Satisfaction , Pandemics , Quality of Life , SARS-CoV-2 , Surveys and Questionnaires
12.
BMJ Open ; 12(1): e056009, 2022 01 03.
Article in English | MEDLINE | ID: mdl-34980628

ABSTRACT

OBJECTIVES: This study aims to identify levels of adherence to antiretroviral therapy (ART) drugs and factors associated with them in Northwest Ethiopia. We hypothesise that in the era of COVID-19, there would be suboptimal adherence to ART drugs. DESIGN: An observational cross-sectional study was conducted. Factors associated with the level of adherence were selected for multiple logistic regressions at a p value of less than 0.2 in the analysis. Statistically significant associated factors were identified at a p value less than 0.05 and adjusted OR with a 95% CI. SETTING: The study was conducted in one specialised hospital and three district hospitals found in the South Gondar zone, Northwest Ethiopia. PARTICIPANTS: About 432 people living with HIV/AIDS receiving highly active ART in South Gondar zone public hospitals and who have been on treatment for more than a 3-month period participated in the study. PRIMARY AND SECONDARY OUTCOME MEASURES: Levels of adherence to ART drugs and their associated factors. RESULTS: Among 432 study participants, 81.5% (95% CI: 78% to 85.2%) of participants were optimally adherent to ART drugs. Determinants of a low level of adherence: stigma or discrimination (OR=0.4, p=0.016), missed scheduled clinical visit (OR=0.45, p=0.034), being on tuberculosis treatment (OR=0.45, p=0.01), recent CD4 cell count less than 500 cells/mm3 (OR=0.3, p=0.023) and patients who had been on WHO clinical stage III at the time of ART initiation (OR=0.24, p=0.027) were factors significantly associated with adherence to ART drugs. CONCLUSIONS: Level of adherence was relatively low compared with some local studies. The intervention targeted to reduce discrimination, counselling before initiation of treatment and awareness regarding compliance is advised to improve adherence to antiretroviral regimens.


Subject(s)
COVID-19 , HIV Infections , Cross-Sectional Studies , Ethiopia , HIV Infections/drug therapy , Humans , Medication Adherence , SARS-CoV-2
13.
Clin Infect Dis ; 2022 Jan 07.
Article in English | MEDLINE | ID: mdl-35016216

ABSTRACT

BACKGROUND: The degree to which the 2019 novel coronavirus disease (COVID-19) pandemic will affect the US human immunodeficiency virus (HIV) epidemic is unclear. METHODS: We used the Johns Hopkins Epidemiologic and Economic Model to project HIV infections from 2020 to 2025 in 32 US metropolitan statistical areas (MSAs). We sampled a range of effects of the pandemic on sexual transmission (0-50% reduction), viral suppression among people with HIV (0-40% reduction), HIV testing (0-50% reduction), and pre-exposure prophylaxis use (0-30% reduction), and indexed reductions over time to Google Community Mobility Reports. RESULTS: Simulations projected reported diagnoses would drop in 2020 and rebound in 2021 or 2022, regardless of underlying incidence. If sexual transmission normalized by July 2021 and HIV care normalized by January 2022, we projected 1,161 (1%) more infections from 2020 to 2025 across all 32 cities than if COVID had not occurred. Among "optimistic" simulations in which sexual transmission was sharply reduced and viral suppression was maintained we projected 8% lower incidence (95% credible interval: 14% lower to no change). Among "pessimistic" simulations where sexual transmission was largely unchanged but viral suppression fell, we projected 11% higher incidence (1% to 21% higher). MSA-specific projections are available at jheem.org?covid. CONCLUSIONS: The effects of COVID-19 on HIV transmission remain uncertain and differ between cities. Reported diagnoses of HIV in 2020-2021 are likely to correlate poorly with underlying incidence. Minimizing disruptions to HIV care is critical to mitigating negative effects of the COVID-19 pandemic on HIV transmission.

14.
Preprint in English | medRxiv | ID: ppmedrxiv-22269049

ABSTRACT

ObjectiveTo conduct a comprehensive systematic review and meta-analysis of all recommended SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) vaccines in people living with HIV (PLWH), as well as an overview of the safety, tolerability, and efficacy of the vaccines in PLWH. MethodsWe searched six databases, Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Medline, Medrxiv, Global research on COVID-19 database, and Google Scholar for studies investigating the effects of SARS-CoV-2 vaccines on PLWH. Results of the association were summarised by SARS-CoV IgG seroconversion and level, vaccines efficacy and tolerability. A meta-analysis was performed for studies, using random-effects model and a pooled RR with 95% CI was reported. ResultsTwenty-three of the 1052 studies screened met the inclusion criteria. The review included 28, 246 participants among whom 79.55% (22,469/28, 246) were PLWH with median CD4 [≥] 200 cells/{micro}L. The pooled estimate of SARS-CoV-2 IgG seroconversion and positive neutralizing antibodies after the second vaccination dose between PLWH vs HIV negative were RR 0.95 (95%CI: 0.92 - 0.99, P = 0.006) and 0.88 (95%CI: 0.82- 0.95, P = 0.0007), respectively. The mean difference of IgG antibodies level (BAU/ml) was found higher in mRNA vaccines MD -1444.97 (95%CI: -1871.39, -1018.55). PLWH with CD4 less than 500 cells/ {micro}l had 15% risk reduction of neutralizing antibodies response compared to those with CD4 [≥] 500 cells/{micro}l (P = 0.003). The SARS-CoV-2 vaccine effectiveness was 65% (95%CI: 56%-72%, P <0.001) among vaccinated compared to unvaccinated PLWH. PLWH with CD4 count <350 cells/{micro}l had lower vaccine effectiveness compared to CD4 count [≥] 350 cells/{micro}l with 59% vs 72%, respectively. Vaccine tolerability was the same between PLWH and HIV negatives. ConclusionAccording to our findings, PLWH with CD4 [≥] 200 cells/{micro}L had lower immunogenicity and antigenicity in COVID-19 vaccines than HIV negatives. Additional doses of SARS-CoV- 2 vaccination are needful in PLWH.

15.
Preprint in English | medRxiv | ID: ppmedrxiv-22269178

ABSTRACT

BackgroundWe investigated the effect of HIV on COVID-19 outcomes with attention to selection bias due to differential testing and to comorbidity burden. MethodsRetrospective cohort analysis using four hierarchical outcomes: positive SARS-CoV-2 test, COVID-19 hospitalization, intensive care unit (ICU) admission, and hospital mortality. The effect of HIV status was assessed using traditional covariate-adjusted, inverse probability weighted (IPW) analysis based on covariate distributions for testing bias (testing IPWs), HIV infection status (HIV IPWs), and combined models. Among PWH, we evaluated whether CD4 count and HIV plasma viral load (pVL) discriminated between those who did or did not develop study outcomes using receiver operating characteristic analysis. ResultsBetween March and November 2020, 63,319 people were receiving primary care services at UCSD, of whom 4,017 were people living with HIV (PWH). PWH had 2.1 times the odds of a positive SARS-CoV-2 test compared to those without HIV after weighting for potential testing bias, comorbidity burden, and HIV-IPW (95% CI 1.6-2.8). Relative to persons without HIV, PWH did not have an increased rate of COVID-19 hospitalization after controlling for comorbidities and testing bias [adjusted incidence rate ratio (aIRR): 0.5, 95% CI: 0.1 - 1.4]. PWH had neither a different rate of ICU admission (aIRR:1.08, 95% CI; 0.31 - 3.80) nor in-hospital death (aIRR:0.92, 95% CI; 0.08 - 10.94) in any examined model. Neither CD4 count nor pVL predicted any of the hierarchical outcomes among PWH. ConclusionsPWH have a higher risk of COVID-19 diagnosis but similar outcomes compared to those without HIV. Summary pointAfter considering the effects of potential bias due to differential testing, comorbidities, and other patient characteristics, people with HIV had an increased rate of SARS-CoV-2 positivity and similar rates of hospitalization, ICU admission, and death.

16.
Preprint in English | bioRxiv | ID: ppbiorxiv-475725

ABSTRACT

SARS-CoV-2 and HIV-1 are RNA viruses that have killed millions of people worldwide. Understanding the similarities and differences between these two infections is critical for understanding disease progression and for developing effective vaccines and therapies, particularly for 38 million HIV-1+ individuals who are vulnerable to SARS-CoV-2 co-infection. Here, we utilized single-cell transcriptomics to perform a systematic comparison of 94,442 PBMCs from 7 COVID-19 and 9 HIV-1+ patients in an integrated immune atlas, in which 27 different cell types were identified using an accurate consensus single-cell annotation method. While immune cells in both cohorts show shared inflammation and disrupted mitochondrial function, COVID-19 patients exhibit stronger humoral immunity, broader IFN-I signaling, elevated Rho GTPase and mTOR pathway activities, and downregulated mitophagy. Our results elucidate transcriptional signatures associated with COVID-19 and HIV-1 that may reveal insights into fundamental disease biology and potential therapeutic targets to treat these viral infections. HighlightsO_LICOVID-19 and HIV-1+ patients show disease-specific inflammatory immune signatures C_LIO_LICOVID-19 patients show more productive humoral responses than HIV-1+ patients C_LIO_LISARS-CoV-2 elicits more enriched IFN-I signaling relative to HIV-I C_LIO_LIDivergent, impaired metabolic programs distinguish SARS-CoV-2 and HIV-1 infections C_LI

17.
AIDS ; 2022 Jan 10.
Article in English | MEDLINE | ID: mdl-35013084

ABSTRACT

OBJECTIVE: To assess the impact of coronavirus disease 2019 (COVID-19) epidemics on the prevention and care for HIV and other sexually transmitted infections at a major reference centre providing preventive and clinical services in Catalonia, Spain. DESIGN: We retrospectively compared anonymized clinical and laboratory data from March to December 2020 vs. 2019. METHODS: Monthly clinical data on HIV preexposure and postexposure prophylaxis users and on adults with HIV infection were retrieved from the administrative hospital database. Monthly tests for HIV, hepatitis B and C, Treponema pallidum, Neisseria gonorrhoeae, and Chlamydia trachomatis, and plasma lipids and glucose were recovered from the laboratory database. RESULTS: There were less (↓28%, P = 0.003) but more advanced (mean CD4+ cells/µl 305 vs. 370, P < 0.001) HIV infections and more gonorrhoea (↑39%, P < 0.001) and chlamydia (↑37%, P < 0.001) infections in 2020 vs. 2019. In people with HIV, rates of HIV RNA at least 50 copies/ml remained stable (11 vs. 11%, P = 0.147) despite less scheduled visits (↓25%, P < 0.001). However, they had less antiretroviral prescription changes (↓10%, P = 0.018), worse plasma lipids [mean total cholesterol 190 vs. 185 mg/dl, P < 0.001; mean low-density lipoprotein (LDL) cholesterol 114 vs. 110 mg/dl, P < 0.001; mean triglycerides 136 vs. 125 mg/dl, P < 0.001; mean high-density lipoprotein (HDL) cholesterol 47 vs. 48 mg/dl, P = 006], and an excess of mortality (↑264%, P = 0.006) due in great part not only to COVID-19 but also to other causes. CONCLUSION: In our setting, COVID-19 epidemics was associated with an increase in some prevalent sexually transmitted infections, with less but more advanced HIV infections, and with worse nonvirologic healthcare outcomes and higher mortality in people living with HIV.

18.
AIDS ; 2022 Jan 10.
Article in English | MEDLINE | ID: mdl-35013085

ABSTRACT

OBJECTIVES: COVID-19 vaccination is reportedly efficient in people living with HIV (PLHIV) but vaccine trials included participants with normal CD4+ T-cell counts. We analyzed seroconversion rates and antibody titers following 2-dose vaccination in PLHIV with impaired CD4+ T-cell counts. METHODS: We collected retrospective post-vaccination SARS-COV-2 serology results available in a university hospital for PLHIV vaccinated between March and September, 2021 who were tested for anti-spike antibodies from 8 to 150 days following dose 2. Antibody titers were compared in PLHIV with CD4+T-cells < 200/µL, 200 < CD4+T-cells < 500/µL and CD4+T-cell > 500/µl at vaccination. RESULTS: 105 PLHIV were included: n = 54 in the CD4 < 500/µL group (n = 18 with CD4 < 200/µL, n = 36 with 200 < CD4 < 500/µL) and 51 in the CD4 > 500/µL group. They received 2 doses of BNT162b2 (75%), mRNA-1273 (8.5%) or ChAdOx1 nCoV-19 (16.5%). The median time from vaccine dose 2 to serology was consistent across all groups (73 days, interquartile range [29-97], p = 0.14). Seroconversion rates were 100% in the CD4 > 500/µL group but 89% if CD4 < 500/µL (22% and 5.5% seronegative in the CD4 < 200/µl and 200 < CD4 < 500/µL groups, respectively). Median antibody titers were 623.8 BAU/mL [262.2-2288] in the CD4 < 500/µl group versus 334.3 BAU/mL [69.9-933.9] in the CD4 < 500/µL group (p = 0.003). They were lowest in the CD4 < 200/µL group: 247.9 BAU/mL [5.88-434.9] (p = 0.0017) with only 44% achieving antibody titers above the putative protection threshold of 260 BAU/mL. CONCLUSIONS: PLHIV with CD4+T-cells <500/µL and notably <200/µL had significantly lower seroconversion rates and anti-spike antibody titers compared to PLHIV with CD4+T-cell > 500/µL, warranting the consideration of targeted vaccine strategies in this fragile population.

20.
AIDS Behav ; 2022 Jan 13.
Article in English | MEDLINE | ID: mdl-35024992

ABSTRACT

People living with HIV (PLWH) are particularly vulnerable to worsened outcomes of COVID-19. Therefore, the purpose of this work was to provide a scoping review of the literature to assess the risk factors for COVID-19 mortality among PLWH. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR), searches were conducted in PubMed, Scopus, Global Health, and WHO Coronavirus Database. Articles were eligible for inclusion if they were in English, included PLWH who died after COVID-19 infection, and described risk factors for mortality. Results were descriptively synthesized and pooled thereafter. Study quality was assessed using the Joanna Brigg Institute's critical appraisal tools. 20 studies were eligible for inclusion, with the pooled death rate being 11.7%. Age was a major risk factor, especially after 50 (23.2%) and after 70 (41.8%), and males had a death rate nearly double that of females. As total comorbidities increased, the death rate also greatly increased; among those with comorbidities, the highest fatality rates were those with cardiovascular disease (30.2%), chronic kidney disease (23.5%), obesity (22.4%), and diabetes (18.4%). Other risk factors for mortality among PLWH included having a Black racial background, being an injection drug user, being a smoker, and having a CD4 cell count below 200. There is a need to better study confounding factors, and to understand how vaccination influences mortality risk. Overall, the findings highlight a need to ensure that focus is placed on the varying demographics of PLWH amidst COVID-19 control efforts.

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