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感染新冠病毒的艾滋病毒感染者:来自马德里一家三级医院的经验

SARS-COV-2 Infection in People Living with HIV: Experience from a Tertiary Hospital in Madrid.

作者信息

González Guembe Maria, Tisner Pensado Yago, Tejerina Picado Francisco, Diez Cristina, Pérez Latorre Leire, Fanciulli Chiara, Parras Vázquez Francisco, López Bernaldo de Quirós Juan Carlos, Berenguer Juan, Padilla Ortega Belen, Machado Marina, Valerio Minero Maricela, Muñoz Garcia Patricia, Bouza Santiago Emilio, Galar Alicia, Catalan Pilar, Alonso Roberto, Bellón Jose M, Aldámiz-Echevarría Lois Teresa

机构信息

Universidad Complutense de Madrid, Seneca Av. Madrid, Spain.

Microbiology and Infectious Diseases Department, Gregorio Marañón Hospital, Madrid, Spain.

出版信息

AIDS Res Hum Retroviruses. 2022 May;38(5):394-398. doi: 10.1089/AID.2021.0159. Epub 2022 Jan 28.

Abstract

Since SAR-COV-2 infection emerged and spread worldwide, little is known about its impact on people living with human immunodeficiency virus (HIV). We performed a single-center retrospective study to describe the potential particularities and risk factors for respiratory failure (RF) in that population. This single-center retrospective study included patients infected with HIV, whose current follow-up is run in this center, above18 years of age, with diagnosis of SARS-CoV-2 infection between March 5, 2020 and April 15, 2021. We collected data regarding HIV immunological and virological status, main epidemiological characteristics, as well as those conditions considered to potentially influence in SARS-CoV-2 evolution; and clinical, microbiological, radiological, respiratory status, and survival concerning coronavirus disease 2019 (COVID-19). We compared all that, for patients with and without RF and performed a logistic regression for suspected risk factors for RF. One hundred seventy-seven HIV patients were diagnosed from COVID-19 (mean age 53.8 years, 81.3% male). At diagnosis, 95.5% were receiving ART and 91.3% had undetectable viral load, with median CD4 count of 569 cells/μL. One hundred thirty-eight patients (78.4%) had symptoms, 44 (25%) developed RF and 53 (31%) developed bilateral pneumonia. The most commonly used treatments were: steroids (26.7%) and hydroxychloroquine (13.1%). When comparing patients with and without RF, we found statistically significant differences for 20 of the analyzed variables such as age ( < .001) and CD4 ( 0.002), and route of HIV transmission by intravenous drug users IVDU ( 0.002) were determined. In multivariate analysis, age [odds ratio (OR) 1.095] and CD4 count less than 350 cells/μL (OR 3.36) emerged as risk factor for RF. People living with HIV whose CD4 count is <350 cells are at higher risk of developing RF when infected by SARS-CoV-2.

摘要

自严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染在全球出现并传播以来,人们对其对人类免疫缺陷病毒(HIV)感染者的影响知之甚少。我们进行了一项单中心回顾性研究,以描述该人群中呼吸衰竭(RF)的潜在特殊性和危险因素。这项单中心回顾性研究纳入了年龄在18岁以上、于2020年3月5日至2021年4月15日期间确诊为SARS-CoV-2感染、目前在本中心接受随访的HIV感染者。我们收集了有关HIV免疫和病毒学状态、主要流行病学特征以及那些被认为可能影响SARS-CoV-2演变的情况的数据;以及与2019冠状病毒病(COVID-19)相关的临床、微生物学、放射学、呼吸状态和生存情况的数据。我们对有和没有RF的患者进行了所有这些比较,并对RF的疑似危险因素进行了逻辑回归分析。177名HIV患者被诊断为COVID-19(平均年龄53.8岁,81.3%为男性)。在诊断时,95.5%的患者正在接受抗逆转录病毒治疗(ART),91.3%的患者病毒载量检测不到,CD4细胞计数中位数为569个/μL。138名患者(78.4%)出现症状,44名(25%)发生RF,53名(31%)发生双侧肺炎。最常用的治疗方法是:类固醇(26.7%)和羟氯喹(13.1%)。在比较有和没有RF的患者时,我们发现20个分析变量存在统计学显著差异,如年龄(<0.001)和CD4(0.002),并且确定了静脉吸毒者(IVDU)传播HIV的途径(0.002)。在多变量分析中,年龄[比值比(OR)1.095]和CD4细胞计数低于350个/μL(OR 3.36)成为RF的危险因素。CD4细胞计数<350个的HIV感染者在感染SARS-CoV-2时发生RF的风险更高。

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