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SARS-CoV-2 感染合并 HIV 感染者:一项单中心前瞻性队列研究。

SARS-CoV-2 infection in persons living with HIV: A single center prospective cohort.

机构信息

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.

出版信息

J Med Virol. 2021 Feb;93(2):1145-1149. doi: 10.1002/jmv.26352. Epub 2020 Oct 8.

Abstract

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.

摘要

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。

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