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简要报告:COVID-19 患者的病毒学和免疫学结果。

Brief Report: Virologic and Immunologic Outcomes for HIV Patients With Coronavirus Disease 2019.

机构信息

Departments of AIDS Prevention.

Virology; and.

出版信息

J Acquir Immune Defic Syndr. 2021 Feb 1;86(2):213-218. doi: 10.1097/QAI.0000000000002540.

Abstract

BACKGROUND

To describe the virologic and immunologic outcomes among people living with HIV (PLHIV) coinfected with SARS-CoV-2.

SETTING

Wuhan, China.

METHODS

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.

RESULTS

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).

CONCLUSION

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.

摘要

背景

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。

地点

中国武汉。

方法

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。

结果

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)。

结论

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。

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