与未感染 HIV 的人群相比，HIV 感染者感染 SARS-CoV-2 的情况：来自 MACS-WIHS 联合队列研究的调查结果。

SARS-CoV-2 Infection Among People Living With HIV Compared With People Without HIV: Survey Results From the MACS-WIHS Combined Cohort Study.

机构信息

Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.

Department of Neurology, State of New York Downstate Health Sciences University, Brooklyn, NY.

出版信息

J Acquir Immune Defic Syndr. 2022 Jan 1;89(1):1-8. doi: 10.1097/QAI.0000000000002822.

DOI:10.1097/QAI.0000000000002822

PMID:34878431

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8667184/

Abstract

BACKGROUND

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19) symptoms among people living with HIV (PLWH) are not well described.

SETTING

Longitudinal survey within the MACS/WIHS Combined Cohort Study (MWCCS) of PLWH compared with similar HIV-seronegative (SN) individuals.

METHODS

Telephone-administered survey of MWCCS participants at 13 clinical research sites across the United States addressing COVID-19 symptoms, SARS-CoV-2 testing, and pandemic impact on social distancing and antiretroviral therapy (ART) use. Primary data collection occurred during May (wave 1), June-July (wave 2), and August-September, 2020 (wave 3).

RESULTS

One-third of MWCCS participants were tested for SARS-CoV-2 infection; 10% was tested ≥2 times. Similar proportions of PLWH and SN participants were tested, but SARS-CoV-2 positivity was higher among PLWH than among SN individuals (9.4% vs 4.8%, P = 0.003). Odds of SARS-CoV-2 positivity remained higher among PLWH after adjusting for age, sex, race/ethnicity, and study site (adjusted odds ratio = 2.0, 95% confidence interval = 1.2 to 3.2). SARS-CoV-2 positivity was not associated with CD4 cell counts among PLWH. Among SARS-CoV-2 positive participants, 9% had no symptoms, 7% had 1-2 mild symptoms, and 84% had ≥3 symptoms. Most of the (98%) participants reported physical distancing during all survey waves; self-reported ART adherence among PLWH was not adversely affected during the pandemic compared with the previous year (similar adherence in 89% of participants, improved in 9% of participants, and decreased in 2% of participants).

CONCLUSIONS

Despite similar SARS-CoV-2 testing and physical distancing profiles by HIV serostatus among MWCCS participants, PLWH who reported SARS-CoV-2 testing were more likely to have a positive test result. Additional studies are needed to determine whether and why PLWH are at increased risk of SARS-CoV-2 infection.

摘要

背景

人们对于感染严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）和患有 2019 年冠状病毒病（COVID-19）的艾滋病毒感染者（PLWH）的症状知之甚少。

地点

在美国的 MACS/WIHS 联合队列研究（MWCCS）中对 PLWH 进行的纵向调查，与类似的 HIV 血清阴性（SN）个体进行了比较。

方法

通过电话对美国 13 个临床研究地点的 MWCCS 参与者进行调查，调查内容涉及 COVID-19 症状、SARS-CoV-2 检测以及大流行对社交距离和抗逆转录病毒治疗（ART）使用的影响。主要数据收集发生在 2020 年 5 月（第 1 波）、6-7 月（第 2 波）和 8-9 月（第 3 波）。

结果

MWCCS 参与者中有三分之一接受了 SARS-CoV-2 感染检测；10%的人接受了≥2 次检测。PLWH 和 SN 参与者接受检测的比例相似，但 PLWH 中 SARS-CoV-2 阳性的比例高于 SN 个体（9.4%比 4.8%，P=0.003）。在调整了年龄、性别、种族/族裔和研究地点后，PLWH 中 SARS-CoV-2 阳性的可能性仍然更高（调整后的优势比=2.0，95%置信区间=1.2 至 3.2）。PLWH 中 SARS-CoV-2 阳性与 CD4 细胞计数无关。在 SARS-CoV-2 阳性参与者中，9%没有症状，7%有 1-2 种轻度症状，84%有≥3 种症状。大多数（98%）参与者在所有调查波次都报告了保持社交距离；与前一年相比，PLWH 的自我报告的 ART 依从性在大流行期间并未受到不利影响（89%的参与者保持相同的依从性，9%的参与者有所改善，2%的参与者有所下降）。