Department of Hematology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.
Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, No.10 You'anmenwai Xitoutiao, Fengtai District, Beijing, 100069, China.
Curr HIV/AIDS Rep. 2022 Jun;19(3):167-176. doi: 10.1007/s11904-022-00606-0. Epub 2022 Apr 8.
The impact of HIV infection on the natural history of COVID-19 is unknown, given the recency of the human spread of SARS-CoV-2 (CoV). We reviewed published case series/reports of CoV-HIV coinfections to clarify epidemiologic and clinical features in China, the first nation with pandemic experience.
Assuming that HIV-infected persons were at average risk of CoV infection in Wuhan, we estimated HIV-CoV coinfected persons to number 412 (95%CI: 381-442); our review encompassed an estimated 16.7% (69/412) of Wuhan. Men (many of whom reported sex with other men) accounted for 71.1% (54/76) of the cases reported in China. The median age was 48.0 years old (range 24-77, interquartile:37-57). The median CD4+ cell count at the last clinical visit was 421 cells/μL; 83.0% had an undetectable viral load. Among 31 patients with clinical details reported, fatigue (41.9%), respiratory distress (41.9%), and gastrointestinal symptoms (26.7%) were most common. Among the 52 cases reporting COVID-19 clinical severity, 46.2% were severe, 44.2% mild, and 9.6% asymptomatic COVID-19. Late antiretroviral therapy (ART) was reported by 30.4% (7/23) among whom 57.1% (4/7) were confirmed as severe COVID-19. The case fatality rate was 9.1% (3/33). Severe disease and death were less common among persons who took ART prior to the COVID-19 diagnosis. Of 16 reported IL-6 results, 68.7% were within the normal range. Earlier use of ART was associated with a better COVID-19 prognosis with CoV-HIV co-infection reported from China through early 2021, but small sample sizes limit definitive conclusions.
由于 SARS-CoV-2（CoV）的人类传播时间较短，因此 HIV 感染对 COVID-19 自然史的影响尚不清楚。我们对 CoV-HIV 合并感染的已发表病例系列/报告进行了综述，以阐明中国这一首个经历大流行国家的流行病学和临床特征。
假设 HIV 感染者在武汉感染 CoV 的平均风险，我们估计 HIV-CoV 合并感染者人数为 412 人（95%CI：381-442）；我们的综述包括武汉估计的 16.7%（69/412）。男性（其中许多人报告有男男性行为）占中国报告病例的 71.1%（54/76）。中位年龄为 48.0 岁（范围 24-77，四分位间距：37-57）。最后一次临床就诊时的中位 CD4+细胞计数为 421 个/μL；83.0%的病毒载量不可检测。在报告了临床详细信息的 31 名患者中，疲劳（41.9%）、呼吸窘迫（41.9%）和胃肠道症状（26.7%）最为常见。在报告 COVID-19 临床严重程度的 52 例病例中，46.2%为严重，44.2%为轻度，9.6%为无症状 COVID-19。30.4%（7/23）的患者报告接受了晚期抗逆转录病毒治疗（ART），其中 57.1%（4/7）被确认为严重 COVID-19。病例死亡率为 9.1%（3/33）。在 COVID-19 诊断前接受 ART 的患者中，严重疾病和死亡较少见。在报告的 16 例 IL-6 结果中，68.7%在正常范围内。早期使用 ART 与 CoV-HIV 合并感染的 COVID-19 预后较好相关，但小样本量限制了明确结论。
