Departments of AIDS Prevention.
Virology; and.
J Acquir Immune Defic Syndr. 2021 Feb 1;86(2):213-218. doi: 10.1097/QAI.0000000000002540.
To describe the virologic and immunologic outcomes among people living with HIV (PLHIV) coinfected with SARS-CoV-2.
Wuhan, China.
Thirty-five coinfected patients were identified by matching the reported cases in National Notifiable Infectious Disease Report system for COVID-19 and HIV in Wuhan by time of April 19, 2020. Questionnaire-based survey and follow-up with blood sample collection were used to obtain characteristics before COVID-19 and after recovery. Nonparametric Mann-Whitney U test, χ2, or Fisher exact test, Mcnemar test, and Wilcoxon test were conducted.
Twenty of the 35 coinfected patients were identified as asymptomatic/mild/moderate COVID-19 (nonsevere group) and 15 were identified as severe/critical (severe group). The severe and nonsevere group had no differences in demographics, HIV baseline status, the intervals between last tests and follow-up tests for CD4+ cell count and HIV-1 viral load (all P > 0.05). Overall, there was a significantly increased number of coinfected patients with HIV-1 viral load ≥20 copies/mL after recovery (P = 0.008). The median viral load increased significantly after recovery in severe group (P = 0.034), whereas no significant change of HIV-1 viral load was observed in the nonsevere group. Limited change of CD4+ cell count was found (all P > 0.05).
The coinfection of SARS-CoV-2 may put PLHIV at greater risk for HIV-1 viral rebound especially for severe/critical COVID-19, whereas it had limited impacts on CD4+ cell count. Whether continuous antiretroviral therapy against HIV infection would have significant impacts on CD4+ cell count among PLHIV coinfected with SARS-CoV-2 needs further research.
描述同时感染严重急性呼吸综合征冠状病毒 2 型（SARS-CoV-2）和人类免疫缺陷病毒（HIV）的人群（PLHIV）的病毒学和免疫学结果。
中国武汉。
通过匹配 2020 年 4 月 19 日之前国家传染病报告系统中报告的 COVID-19 和 HIV 病例，确定了 35 例合并感染的患者。通过问卷调查和随访采集血样，获得 COVID-19 前和康复后的特征。采用非参数 Mann-Whitney U 检验、χ2 检验或 Fisher 确切概率法、McNemar 检验和 Wilcoxon 检验。
35 例合并感染患者中，20 例为无症状/轻症/中症 COVID-19（非重症组），15 例为重症/危重症（重症组）。重症和非重症组在人口统计学特征、HIV 基线状态、CD4+T 细胞计数和 HIV-1 病毒载量的最后一次检测与随访检测之间的时间间隔方面均无差异（均 P > 0.05）。总体而言，在康复后 HIV-1 病毒载量≥20 拷贝/ml 的合并感染患者数量显著增加（P = 0.008）。重症组病毒载量在康复后显著增加（P = 0.034），而非重症组 HIV-1 病毒载量无显著变化。CD4+T 细胞计数的变化有限（均 P > 0.05）。
SARS-CoV-2 的合并感染可能使 PLHIV 面临更大的 HIV-1 病毒反弹风险，特别是对重症/危重症 COVID-19 患者，而对 CD4+T 细胞计数的影响有限。SARS-CoV-2 合并感染的 PLHIV 中，是否继续抗逆转录病毒治疗对 HIV 感染的 CD4+T 细胞计数有显著影响，还需要进一步研究。
