HIV 合并 COVID-19 患者的细菌合并感染、机会性疾病和持续免疫抑制的风险较低。
Low risk of bacterial co-infection, opportunistic diseases, and persistent immunosuppression in people living with HIV and COVID-19.
机构信息
HIV-Unit, Department of Infectious Diseases, Ramon y Cajal Hospital, Cra Colmenar Km 9.1, 28034, Madrid, Spain.
Laboratory of Immunovirology, Infectious Diseases, Ramon y Cajal Hospital, Madrid, Spain.
出版信息
Infection. 2022 Aug;50(4):1013-1017. doi: 10.1007/s15010-022-01811-0. Epub 2022 Mar 31.
PURPOSE
SARS-CoV-2 infection produces lymphopenia and CD4+ T-cell decrease, which could lead to a higher risk of bacterial co-infection or impair immunological evolution in people living with HIV (PLWH).
METHODS
We investigated the rate of co-infection and superinfection, and the evolution of CD4+ count and CD4+/CD8+ ratio, in hospitalized PLWH with COVID-19.
RESULTS
From March to December 2020, 176 PLWH had symptomatic COVID-19 and 62 required hospitalization (median age, 56 years, 89% males). At admission, 7% and 13% of patients had leukocytosis or increased procalcitonin values and 37 (60%) received empiric antibiotic therapy, but no bacterial co-infection was diagnosed. There were seven cases of superinfection (12%), and one case of P. jiroveci pneumonia during ICU stay. No significant change in CD4+ count or CD4+/CD8+ ratio was observed after discharge.
CONCLUSION
Bacterial co-infection is not frequent in PLWH with COVID-19. Immune recovery is observed in most of patients after the disease.
目的
SARS-CoV-2 感染可导致淋巴细胞减少和 CD4+T 细胞减少，这可能导致 HIV 感染者（PLWH）发生细菌合并感染的风险增加或免疫进化受损。
方法
我们研究了住院 COVID-19 合并感染和再感染的 PLWH 中 CD4+计数和 CD4+/CD8+比值的演变。
结果
2020 年 3 月至 12 月，176 例 PLWH 出现有症状的 COVID-19，62 例需要住院治疗（中位年龄 56 岁，89%为男性）。入院时，7%和 13%的患者白细胞增多或降钙素原升高，37 例（60%）接受经验性抗生素治疗，但未诊断细菌合并感染。有 7 例再感染（12%），1 例在 ICU 期间发生肺孢子菌肺炎。出院后 CD4+计数或 CD4+/CD8+比值无明显变化。
结论
COVID-19 合并感染的 PLWH 中细菌合并感染不常见。大多数患者在疾病后观察到免疫恢复。
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