ABSTRACT
BACKGROUND: People living with HIV (PLHIV) are at increased risk of COVID-19 death. However, information about whether factors related to the HIV-infection influence the COVID-19 outcome still remains conflicting. OBJECTIVE: Here, we evaluate the risk factors for fatal COVID-19 in a cohort of PLHIV from the Moscow region, aged >18 years and diagnosed with COVID-19 between March 2020 and December 2021. METHODS: Demographic, clinical and laboratory data were compared between different COVID-19 outcomes. To analyze the risk factors associated with COVID-19 death, we employed the logistic regression method. A total of 566 PLHIV were included in the analysis. RESULTS: The majority of individuals, 338 (59.7%), were male; 194 (34.3%) were on antiretroviral therapy; 296 (52.3%) had a comorbidity; 174 (30.7%) of patients had drug and/or alcohol dependence; 160 (33.1%) patients had CD4 counts <200 cells/µl; 253 (51.9%) had undetectable viral load. Our analysis revealed that PLHIV >55 years old (OR, 12.88 [95% CI, 2.32-71.62]), patients with a viral load of more than 1000 copies/ml (OR, 2.45 [95%CI, 1.01-5.98]) and with CD4 counts <200 cell/µl (OR, 2.54 [95%CI, 1.02-6.28]), as well as with a history of cachexia (OR, 3.62 [95%CI, 1.26-10.39]) and pneumocystis pneumonia (OR, 2.47 [95%CI, 1.03-5.92]), and drug/alcohol dependence (OR, 2.70 [95%CI, 1.36-5.39]) were significantly more likely to die from COVID-19. CONCLUSION: These data show that people with advanced HIV-1 infection have an increased risk of fatal COVID-19 outcomes and that there is a need to improve this population's access to health services and, hence, increase their survival rates.
Subject(s)
Alcoholism , Anti-HIV Agents , COVID-19 , HIV Infections , Humans , Male , Female , Middle Aged , HIV Infections/complications , HIV Infections/drug therapy , Cohort Studies , Alcoholism/complications , Anti-HIV Agents/therapeutic use , COVID-19/complicationsABSTRACT
Tat, the trans-activator of transcription, is a multifunctional HIV-1 protein that can induce chronic inflammation and the development of somatic diseases in HIV-infected patients. Natural polymorphisms in Tat can impact the propagation of the inflammatory signal. Currently, Tat is considered an object for creating new therapeutic agents. Therefore, the identification of Tat protein features in various HIV-1 variants is a relevant task. The purpose of the study was to characterize the genetic variations of Tat-A6 in virus variants circulating in the Moscow Region. The authors analyzed 252 clinical samples from people living with HIV (PLWH) with different stages of HIV infection. Nested PCR for two fragments (tat1, tat2) with subsequent sequencing, subtyping, and statistical analysis was conducted. The authors received 252 sequences for tat1 and 189 for tat2. HIV-1 sub-subtype A6 was identified in 250 samples. The received results indicated the features of Tat1-A6 in variants of viruses circulating in the Moscow Region. In PLWH with different stages of HIV infection, C31S in Tat1-A6 was detected with different occurrence rates. It was demonstrated that Tat2-A6, instead of a functional significant 78RGD80 motif, had a 78QRD80 motif. Herewith, G79R in Tat2-A6 was defined as characteristic amino acid substitution for sub-subtype A6. Tat2-A6 in variants of viruses circulating in the Moscow Region demonstrated high conservatism.
