Are HIV-infected people at risk group for COVID-19 morbidity and severe course?

Abstract

Opinions regarding the frequency and severity of COVID-19 clinical course in HIV-infected vs. HIV-negative people are controversial. The study was aimed to assess the incidence and severity of COVID-19 clinical course in HIV-infected people in comparison with the general population in the years 2020–2023. The information resource COVID-19 accounting of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing in Perm Region and Regional information and analytical medical system “Unified Health Care Informational System in Perm Region” over 2020–2023 has been studied. The degree of immunodeficiency and viral load (VL) in HIV-infected patients (2459 and 2364 patients, respectively) were taken into account on the based on the data from medical examinations conducted during 6 months before COVID-19 diagnosis. The incidence rate among HIV-infected people was calculated per 100 thousand of people living with HIV (PLHIV), among the general population — per 100 thousand of residents. The comparison of morbidity rates was carried out using the Student’s t-test. The significance of differences in COVID-19 incidence rate depending on the level of immunodeficiency and VL according to data from limited sample studies was assessed using the distribution-free test χ2 and Fischer’s exact test. The results showed that COVID-19 incidence among different age and social groups of PLHIV is 1.3–2.6 times lower than among similar groups in HIV-negative cohort. The reduced COVID-19 incidence is recorded mainly in patients with relatively minor immune disorders and low VL. COVID-19 incidence increases in HIV-infected people with low CD4 lymphocyte count and high VL. At the same time, COVID-19 in HIV-infected as well as in HIV-negative people occurs mainly in a mild form. With severe immunodeficiency and high VL in HIV-infected people, the proportion of moderate and severe clinical forms of COVID-19 increases.

Keywords

• covid-19
• hiv-infected
• hiv-negative
• morbidity
• severity of clinical course
• viral load
• cd4 lymphocytes