Department of Public Health Sciences, Penn State College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, USA.
Center for Neural Engineering, Department of Engineering, Science and Mechanics, The Pennsylvania State University, University Park, PA, USA.
Sci Rep. 2021 Mar 18;11(1):6283. doi: 10.1038/s41598-021-85359-3.
Susceptibility to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the risk of mortality among people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLWHA) is largely unknown. PLWHA are unique due to their altered immune system from their history of chronic HIV infection and their use of antiretroviral therapy, some of which have been used experimentally to treat coronavirus disease 2019 (COVID-19). Therefore, we conducted a systematic review and meta-analysis to assess the epidemiology of SARS-COV-2/HIV coinfection and estimate associated mortality from COVID-19 (Prospero Registration ID: CRD42020187980). PubMed, SCOPUS, OVID and Cochrane Library databases, and medRxiv preprint repositories were searched from January 1, 2020, to December 12, 2020. Data were extracted from studies reporting COVID-19 attack and mortality rates in PLWHA compared to their HIV-negative counterparts. Pooled attack and mortality risks were quantified using random-effects models. We identified 22 studies that included 20,982,498 participants across North America, Africa, Europe, and Asia. The median age was 56 years, and 50% were male. HIV-positive persons had a significantly higher risk of SARS-CoV-2 infection [risk ratio (RR) 1.24, 95% CI 1.05-1.46)] and mortality from COVID-19 (RR 1.78, 95% CI 1.21-2.60) than HIV-negative individuals. The beneficial effects of tenofovir and protease-inhibitors in reducing the risk of SARS-CoV-2 infection and death from COVID-19 in PLWHA remain inconclusive. HIV remains a significant risk factor for acquiring SARS-CoV-2 infection and is associated with a higher risk of mortality from COVID-19. In support of the current Centers for Disease Control and Prevention (CDC) guidelines, persons with HIV need priority consideration for the SARS-CoV-2 vaccine.
人免疫缺陷病毒（HIV）/获得性免疫缺陷综合征（AIDS）（PLWHA）感染者感染严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）的易感性和死亡率风险在很大程度上尚不清楚。PLWHA 由于其慢性 HIV 感染史和抗逆转录病毒治疗（ART）的使用而导致免疫系统发生改变，而其中一些药物已被实验性地用于治疗 2019 年冠状病毒病（COVID-19）。因此，我们进行了一项系统评价和荟萃分析，以评估 SARS-CoV-2/HIV 合并感染的流行病学，并估计 COVID-19 相关死亡率（PROSPERO 注册 ID：CRD42020187980）。从 2020 年 1 月 1 日至 2020 年 12 月 12 日，检索了 PubMed、SCOPUS、OVID 和 Cochrane Library 数据库以及 medRxiv 预印本存储库。从报告 PLWHA 与 HIV 阴性对照者 COVID-19 攻击率和死亡率的研究中提取数据。使用随机效应模型量化合并后的攻击和死亡率风险。我们确定了 22 项研究，共纳入了来自北美、非洲、欧洲和亚洲的 20982488 名参与者。中位年龄为 56 岁，其中 50%为男性。与 HIV 阴性个体相比，HIV 阳性个体感染 SARS-CoV-2 的风险显著增加[风险比（RR）1.24，95%可信区间（CI）1.05-1.46]，COVID-19 死亡率也显著增加[RR 1.78，95% CI 1.21-2.60]。替诺福韦和蛋白酶抑制剂降低 PLWHA 感染 SARS-CoV-2 和 COVID-19 死亡率的有益作用仍不确定。HIV 仍然是感染 SARS-CoV-2 的一个重要危险因素，与 COVID-19 死亡率增加相关。支持当前美国疾病控制与预防中心（CDC）的指南，HIV 感染者需要优先考虑 SARS-CoV-2 疫苗。
