Department of Medicine, Division of Infectious Diseases, ASST Papa Giovanni XXIII, Bergamo, Italy.
Department of Medicine, Unit of HIV related diseases and experimental therapies, ASST Papa Giovanni XXIII, Bergamo, Italy.
J Med Virol. 2021 Feb;93(2):1145-1149. doi: 10.1002/jmv.26352. Epub 2020 Oct 8.
Information about severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in HIV-infected individuals is scarce. In this prospective study, we included HIV (human immunodefeciency virus)-infected individuals (people living with HIV [PLWHIV]) with confirmed SARS-CoV-2 infection and compared them with PLWHIV negative for SARS-CoV-2. We compared 55 cases of SARS-CoV-2 infection with 69 asymptomatic PLWHIV negative for SARS-CoV-2 reverse transcription-polymerase chain reaction and/or serology. There was no significant difference between SARS-CoV-2 positive or negative patients for age distribution, gender, time with HIV infection, nadir CD4-cell counts, type and number of co-morbidities, current CD4 and CD8 counts and type of anti-HIV therapy. Positive patients presented with a median of three symptoms (interquartile range, 1-3). Most common symptoms were fever (76%), dyspnea (35%), anosmia (29%) non-productive cough (27%), fatigue 22%), and ageusia (20%). Ten patients (18%) were completely asymptomatic. Four (7.2%) subjects died of coronavirus disease 2019. Factors significantly (P < .05) associated with death included age and number of co-morbidities, while time from HIV infection and lower current CD4 counts were significant only in univariate analysis. HIV-infected individuals are not protected from SARS-CoV-2 infection or have a lower risk of severe disease. Indeed, those with low CD4 cell counts might have worse outcomes. Infection is asymptomatic in a large proportion of subjects and this is relevant for epidemiological studies.
关于感染人类免疫缺陷病毒（HIV）个体的严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染的信息很少。在这项前瞻性研究中，我们纳入了 HIV 感染个体（HIV 感染者，PLWHIV）并确诊 SARS-CoV-2 感染，并将其与 SARS-CoV-2 阴性的 PLWHIV 进行了比较。我们将 55 例 SARS-CoV-2 感染患者与 69 例 SARS-CoV-2 逆转录-聚合酶链反应和/或血清学阴性的无症状 PLWHIV 进行了比较。SARS-CoV-2 阳性或阴性患者在年龄分布、性别、HIV 感染时间、CD4 细胞计数最低值、合并症的类型和数量、当前 CD4 和 CD8 计数以及抗 HIV 治疗类型方面均无显著差异。阳性患者中位出现 3 种症状（四分位间距，1-3）。最常见的症状是发热（76%）、呼吸困难（35%）、嗅觉丧失（29%）、干咳（27%）、疲劳（22%）和味觉丧失（20%）。10 例患者（18%）完全无症状。4 例（7.2%）患者死于 2019 年冠状病毒病。显著（P<0.05）与死亡相关的因素包括年龄和合并症数量，而从 HIV 感染到当前 CD4 计数较低仅在单因素分析中具有显著意义。HIV 感染者不能免受 SARS-CoV-2 感染或患严重疾病的风险较低。实际上，那些 CD4 细胞计数较低的人可能会有更差的结局。在很大一部分患者中，感染是无症状的，这对流行病学研究很重要。
