Division of HIV, ID, and Global Medicine, University of California, San Francisco, CA, 94110, USA.
Department of Medicine, University of California, San Francisco, CA, USA.
Curr HIV/AIDS Rep. 2022 Oct;19(5):425-432. doi: 10.1007/s11904-022-00618-w. Epub 2022 Aug 5.
In this review, we examine the intersection of the HIV and COVID-19 epidemics with focus on COVID-19-related health outcomes and risk factors for SARS-CoV-2 among people living with HIV (PLWH).
Evidence to date do not suggest a higher incidence of SARS-CoV-2 infection among PLWH compared to the general population, although-once exposed-PLWH are at greater risk of severe COVID-19 outcomes. Key risk factors for severe COVID-19 include non-HIV comorbidities known to be associated with severe disease, as well as HIV-specific risk factors such as low CD4 + T-cell count, unsuppressed viral load, and tuberculosis co-infection. The disproportionate impact of the SARS-CoV-2 pandemic among Black, Latinx, and Native American/Alaskan Native PLWH could worsen pre-existing disparities in health outcomes among PLWH. Data on SARS-CoV-2 vaccine protection among PLWH needs additional study, although some studies suggest decreased humoral responses among those with low CD4 + T-cell counts, while there is a signal of increased vaccine breakthrough rates among PLWH in two large observational cohorts. Data on post-acute sequelae of SARS-CoV-2 (PASC) among PLWH is also limited. PLWH do not have a higher susceptibility to SARS-CoV-2, but once exposed, they are at higher risk of severe COVID-19 outcomes. Additional resources will need to be dedicated to the development of interventions to improve health outcomes and address disparities among PLWH impacted by the COVID-19 pandemic.
在这篇综述中，我们研究了 HIV 和 COVID-19 流行之间的交集，重点关注 COVID-19 相关健康结果和 HIV 感染者（PLWH）中 SARS-CoV-2 的风险因素。
迄今为止的证据表明，与一般人群相比，PLWH 感染 SARS-CoV-2 的发病率并没有更高，尽管一旦暴露，PLWH 患严重 COVID-19 的风险更高。严重 COVID-19 的关键风险因素包括与严重疾病相关的已知非 HIV 合并症，以及 HIV 特异性风险因素，如低 CD4+T 细胞计数、未抑制的病毒载量和结核分枝杆菌合并感染。SARS-CoV-2 大流行在黑人和拉丁裔以及美洲原住民/阿拉斯加原住民 PLWH 中的不成比例影响可能会加剧 PLWH 健康结果中已经存在的差异。关于 PLWH 中 SARS-CoV-2 疫苗保护的数据需要进一步研究，尽管一些研究表明，低 CD4+T 细胞计数者的体液反应下降，而在两个大型观察队列中，PLWH 的疫苗突破性感染率有增加的信号。关于 SARS-CoV-2（PASC）后急性后遗症（PASC）在 PLWH 中的数据也有限。PLWH 对 SARS-CoV-2 的易感性没有更高，但一旦暴露，他们患严重 COVID-19 的风险更高。需要专门拨出额外的资源来制定干预措施，以改善 PLWH 的健康结果，并解决受 COVID-19 大流行影响的 PLWH 的差异。
