奥密克戎变异株感染的 HIV 感染者的 COVID-19 症状较轻：一项横断面研究的结果。
People living with HIV with the Omicron variant infection have milder COVID-19 symptoms: results from a cross-sectional study.
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
AIDS Res Ther. 2024 Aug 10;21(1):53. doi: 10.1186/s12981-024-00633-4.
BACKGROUND
China braces for coronavirus disease 2019 (COVID-19) surge after adjusting the "zero COVID" strategy. We aimed to evaluate and compare the prevalence of clinical symptoms of the Omicron variant infection among people living with HIV (PLWH) and HIV-free people.
METHODS
A cross-sectional study was conducted in Wuchang District, Wuhan, Hubei Province, in December 2022 by a self-administered online survey during the Omicron wave. Participants aged ≥ 18 years with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnosis were recruited. PLWH managed by the local healthcare system were recruited, while HIV-free people were recruited by sending out online surveys through WeChat. We compared the prevalence of clinical symptoms of COVID-19 between PLWH and HIV-free people, and factors associated with symptom occurrence among PLWH were accessed.
RESULTS
Total, 687 PLWH and 1222 HIV-free people were enrolled. After adjusting sex, age, body mass index, comorbidities and COVID-19 vaccination status, the prevalences of all symptoms, including higher degree and long duration of fever (aOR 0.51, 95%CI 0·42 - 0·61; aOR 0.52, 95%CI 0·43 - 0·63), were significantly lower among PLWH than among HIV-free people. Among PLWH, CD4 T lymphocyte count (CD4 count) between 350 ~ 499 cells/µL and detectable HIV viral load (HIV-VL) were associated with significantly decreased risks of fever (aOR 0·63, 95%CI 0·40 - 0·97; aOR 0·56, 95%CI 0·33 - 0·94), headache (aOR 0·61, 95%CI 0·41 - 0·91; aOR 0·55, 95%CI 0·34 - 0·92) and muscle soreness (aOR 0·57, 95%CI 0·39 - 0·84; aOR 0·57, 95%CI 0·39 - 0·84). No apparent association between the symptoms prevalence and three/four doses of inactivated COVID-19 vaccination among PLWH was observed; both males and older age were associated with significantly decreased risks of nasal congestion/runny nose (aOR 0·52, 95%CI 0·32 - 0·82; aOR 0·97, 95%CI 0·96 - 0·99) and headache (aOR 0·58, 95%CI 0·36 - 0·92; aOR 0·96, 95%CI 0·95 - 0·98); older age was associated with significantly decreased risks of higher degree of fever (aOR 0·97, 95%CI 0·95 - 0·98).
CONCLUSIONS
PLWH have significantly milder symptoms of the Omicron variant infection than HIV-free people. PLWH who are male, older, have low CD4 count, and detectable HIV-VL have reduced occurrence of COVID-19 symptoms. However, continuous monitoring should be conducted among PLWH during the COVID-19 pandemic.
背景
中国在调整“零新冠”战略后，正为 2019 年冠状病毒病（COVID-19）疫情高峰做准备。我们旨在评估和比较奥密克戎变异株感染在 HIV 感染者（PLWH）和 HIV 阴性人群中的临床症状患病率。
方法
2022 年 12 月，在湖北省武汉市武昌区进行了一项横断面研究，在奥密克戎波期间通过在线自填问卷进行。招募了年龄≥18 岁且有确诊严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）诊断的参与者。通过当地医疗系统管理的 PLWH 被招募，而 HIV 阴性人群则通过微信发送在线调查进行招募。我们比较了 PLWH 和 HIV 阴性人群中 COVID-19 临床症状的患病率，并探讨了 PLWH 症状发生的相关因素。
结果
共纳入 687 名 PLWH 和 1222 名 HIV 阴性人群。调整性别、年龄、体重指数、合并症和 COVID-19 疫苗接种状况后，PLWH 所有症状的患病率均显著低于 HIV 阴性人群，包括高热程度和持续时间较长（OR 0.51，95%CI 0.42-0.61；OR 0.52，95%CI 0.43-0.63）。在 PLWH 中，CD4 淋巴细胞计数（CD4 计数）在 350-499 个/µL 和可检测到的 HIV 病毒载量（HIV-VL）与发热（OR 0.63，95%CI 0.40-0.97；OR 0.56，95%CI 0.33-0.94）、头痛（OR 0.61，95%CI 0.41-0.91；OR 0.55，95%CI 0.34-0.92）和肌肉酸痛（OR 0.57，95%CI 0.39-0.84；OR 0.57，95%CI 0.39-0.84）显著降低的风险相关。在 PLWH 中，三种/四种灭活 COVID-19 疫苗接种与症状患病率之间没有明显关联；男性和年龄较大与鼻塞/流涕（OR 0.52，95%CI 0.32-0.82；OR 0.97，95%CI 0.96-0.99）和头痛（OR 0.58，95%CI 0.36-0.92；OR 0.96，95%CI 0.95-0.98）的风险显著降低以及高热程度（OR 0.97，95%CI 0.95-0.98）的风险显著降低有关。
结论
PLWH 感染奥密克戎变异株的症状明显较轻。男性、年龄较大、CD4 计数较低和可检测到 HIV-VL 的 PLWH 发生 COVID-19 症状的风险降低。然而，在 COVID-19 大流行期间，应继续对 PLWH 进行监测。
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