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- Title
Risk Factors for SARS-CoV-2 Infection and Severe Outcomes Among People With Human Immunodeficiency Virus: Cohort Study.
- Authors
Hanna, John J; Geresu, Liyu B; Diaz, Marlon I; Ho, Milan; Casazza, Julia A; Pickering, Madison A; Lanier, Heather D; Radunsky, Alexander P; Cooper, Lauren N; Saleh, Sameh N; Bedimo, Roger J; Most, Zachary M; Perl, Trish M; Lehmann, Christoph U; Turer, Robert W; Chow, Jeremy Y; Medford, Richard J
- Abstract
Background Studies on COVID-19 in people with HIV (PWH) have had limitations. Further investigations on risk factors and outcomes of SARS-CoV-2 infection among PWH are needed. Methods This retrospective cohort study leveraged the national OPTUM COVID-19 data set to investigate factors associated with SARS-CoV-2 positivity among PWH and risk factors for severe outcomes, including hospitalization, intensive care unit stays, and death. A subset analysis was conducted to examine HIV-specific variables. Multiple variable logistic regression was used to adjust for covariates. Results Of 43 173 PWH included in this study, 6472 had a positive SARS-CoV-2 result based on a polymerase chain reaction test or antigen test. For PWH with SARS-CoV-2 positivity, higher odds were found for those who were younger (18–49 years), Hispanic White, African American, from the US South, uninsured, and a noncurrent smoker and had a higher body mass index and higher Charlson Comorbidity Index. For PWH with severe outcomes, higher odds were identified for those who were SARS-CoV-2 positive, older, from the US South, receiving Medicaid/Medicare or uninsured, a current smoker, and underweight and had a higher Charlson Comorbidity Index. In a subset analysis including PWH with HIV care variables (n = 5098), those with unsuppressed HIV viral load, a low CD4 count, and no antiretroviral therapy had higher odds of severe outcomes. Conclusions This large US study found significant ethnic, racial, and geographic differences in SARS-CoV-2 infection among PWH. Chronic comorbidities, older age, lower body mass index, and smoking were associated with severe outcomes among PWH during the COVID-19 pandemic. SARS-CoV-2 infection was associated with severe outcomes, but once we adjusted for HIV care variables, SARS-CoV-2 was no longer significant; however, low CD4 count, high viral load, and lack of antiretroviral therapy had higher odds of severe outcomes.
- Subjects
HIV; SARS-CoV-2; COVID-19 pandemic; BODY mass index; ANTIGEN analysis; BK virus
- Publication
Open Forum Infectious Diseases, 2023, Vol 10, Issue 8, p1
- ISSN
2328-8957
- Publication type
Article
- DOI
10.1093/ofid/ofad400