COVID-19 突破性感染在 HIV 感染者和非感染者中的研究：全州队列分析。
COVID-19 breakthrough infections among people living with and without HIV: A statewide cohort analysis.
机构信息
Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA; South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, USA.
South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, USA; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, USA.
出版信息
Int J Infect Dis. 2024 Feb;139:21-27. doi: 10.1016/j.ijid.2023.11.029. Epub 2023 Nov 25.
OBJECTIVES
This study aims to characterize and compare COVID-19 breakthrough infections between people living with and without HIV across different phases of the pandemic.
METHODS
Using statewide HIV cohort data, the study population included adult residents in South Carolina (SC) (>18 years old) who were fully vaccinated between January 02, 2021 and April 14, 2022 when Alpha, Delta, and Omicron variants were circulating in SC. We used the Cox proportional hazard model to investigate the association between HIV infection and breakthrough infection, adjusting for relevant covariates.
RESULTS
Among 2,144,415 vaccinated individuals, 8,335 were people living with HIV (PLWH) and 2,136,080 were people without HIV (PWoH). After propensity score matching, HIV infection was not significantly associated with breakthrough infection rate. However, when comparing breakthrough infections among individuals without any booster dose, PLWH had a higher risk of breakthrough infections (adjusted Hazard Ration: 1.19; 95% confidence interval: 1.03-1.39). Compared to PWoH, PLWH with high levels of clusters of differentiation 4 (CD4) count or viral suppression were not associated with breakthrough infections.
CONCLUSIONS
Our findings do not support a broad conclusion that COVID-19 vaccine effectiveness is lower among PLWH, while we did find that PLWH had a higher risk of breakthrough infection compared to PWoH if they did not receive a booster dose.
目的
本研究旨在描述和比较在大流行的不同阶段，HIV 感染者和非 HIV 感染者的 COVID-19 突破性感染。
方法
利用全州 HIV 队列数据，研究人群包括南卡罗来纳州（SC）的成年居民（>18 岁），他们在 2021 年 1 月 2 日至 2022 年 4 月 14 日期间接种了两剂疫苗，当时 Alpha、Delta 和 Omicron 变异株在 SC 传播。我们使用 Cox 比例风险模型，调整相关协变量，研究 HIV 感染与突破性感染之间的关联。
结果
在 2144415 名接种疫苗的个体中，有 8335 名 HIV 感染者（PLWH）和 2136080 名非 HIV 感染者（PWoH）。经过倾向评分匹配后，HIV 感染与突破性感染率无显著相关性。然而，当比较未接种任何加强针的个体的突破性感染时，PLWH 突破性感染的风险更高（调整后的危险比：1.19；95%置信区间：1.03-1.39）。与 PWoH 相比，CD4 计数或病毒抑制水平较高的 PLWH 与突破性感染无关。
结论
我们的研究结果不支持 HIV 感染者 COVID-19 疫苗有效性较低的广泛结论，但我们确实发现，如果未接种加强针，PLWH 突破性感染的风险高于 PWoH。
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