中国武汉 HIV 感染者感染 SARS-CoV-2 的风险。
Risk of SARS-CoV-2 Infection Among People Living With HIV in Wuhan, China.
机构信息
Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, China.
Wuhan Research Center for Infectious Diseases and Cancer, Chinese Academy of Medical Sciences, Wuhan, China.
出版信息
Front Public Health. 2022 Apr 29;10:833783. doi: 10.3389/fpubh.2022.833783. eCollection 2022.
BACKGROUND
In the era of the COVID-19 pandemic, people living with HIV (PLWH) face more challenges. However, it is unclear if PLWH is more susceptible to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection than HIV-negative individuals. This study aimed to explore the prevalence of the SARS-CoV-2 infection and the associated risk factors among PLWH.
METHODS
From 1 to 30 May 2020, we conducted a cross-sectional survey that enrolled 857 PLWH and 1,048 HIV-negative individuals from the Wuchang district in Wuhan, China. Our data analysis compared the rate of the SARS-CoV-2 infection among PLWH and HIV-negative participants, and the proportions of symptomatic patients and asymptomatic infectors between the two groups. We also assessed the risk factors associated with the SARS-CoV-2 infection among PLWH.
RESULTS
Overall, 14/857 (1.6%) PLWH and 68/1,048 (6.5%) HIV-negative participants were infected with SARS-CoV-2. Among the SARS-CoV-2-infected PLWH participants, 6/14 (42.8%) were symptomatic patients, 4/14 (28.6%) were SARS-CoV-2 nucleic acid-positive asymptomatic infectors, and 4/14 (28.6%) were serology-positive asymptomatic infectors. Among the infected HIV-negative participants, 5/68 (7.4%) patients were symptomatic and 63/68 (92.6%) were serology-positive asymptomatic infectors. The rate of the SARS-CoV-2 infection was lower among the PLWH than in the HIV-negative group (1.96% vs. 5.74%, = 0.001) and the rate of morbidity among the symptomatic patients was similar between the two groups ( = 0.107). However, there were more serology-positive asymptomatic infectors among the infected HIV-negative participants than among the infected PLWH (0.54% vs. 5.46%, = 0.001). Furthermore, being 50 years or older (aOR = 4.50, 95% CI: 1.34-15.13, = 0.015) and having opportunistic infections (aOR = 9.59, 95% CI: 1.54-59.92, = 0.016) were associated with an increased risk of SARS-CoV-2 infection among PLWH.
CONCLUSIONS
PLWH has more varied forms of the SARS-CoV-2 infection than the HIV-negative population and should, therefore, undertake routine screening to avoid late diagnosis. Also, older age (≥50 years) and having opportunistic infections increase the risks of SARS-CoV-2 infection among PLWH.
背景
在 COVID-19 大流行时代，艾滋病毒感染者（PLWH）面临着更多的挑战。然而，目前尚不清楚 PLWH 是否比 HIV 阴性个体更容易感染严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）。本研究旨在探讨 PLWH 中 SARS-CoV-2 感染的流行情况及其相关危险因素。
方法
2020 年 5 月 1 日至 30 日，我们进行了一项横断面研究，纳入了来自中国武汉市武昌区的 857 名 PLWH 和 1048 名 HIV 阴性个体。我们的数据分析比较了 PLWH 和 HIV 阴性参与者中 SARS-CoV-2 感染的发生率，以及两组中症状性患者和无症状感染者的比例。我们还评估了 PLWH 中与 SARS-CoV-2 感染相关的危险因素。
结果
总体而言，857 名 PLWH 中有 14/857（1.6%）和 1048 名 HIV 阴性个体中有 68/1048（6.5%）感染了 SARS-CoV-2。在感染 SARS-CoV-2 的 PLWH 参与者中，6/14（42.8%）为症状性患者，4/14（28.6%）为 SARS-CoV-2 核酸阳性无症状感染者，4/14（28.6%）为血清学阳性无症状感染者。在感染 HIV 阴性的参与者中，5/68（7.4%）患者为症状性，63/68（92.6%）为血清学阳性无症状感染者。PLWH 中 SARS-CoV-2 感染的发生率低于 HIV 阴性组（1.96%比 5.74%， = 0.001），两组症状性患者的发病率相似（ = 0.107）。然而，感染 HIV 阴性参与者中有更多的血清学阳性无症状感染者（0.54%比 5.46%， = 0.001）。此外，50 岁及以上（OR = 4.50，95%CI：1.34-15.13， = 0.015）和患有机会性感染（OR = 9.59，95%CI：1.54-59.92， = 0.016）与 PLWH 中 SARS-CoV-2 感染的风险增加相关。
结论
PLWH 感染 SARS-CoV-2 的形式比 HIV 阴性人群更为多样，因此应进行常规筛查，避免漏诊。此外，年龄较大（≥50 岁）和患有机会性感染会增加 PLWH 感染 SARS-CoV-2 的风险。
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