People with HIV face similar risk for COVID-19 as general population
People with HIV do not have a higher or lower risk for severe COVID-19 than the general population and should receive a similar treatment approach, according to a study published in The Lancet HIV.
People living with HIV (PLWH) “should not be considered protected from SARS-CoV-2 infection or as having lower risk of severe disease,” Pilar Vizcarra, MD, of the department of infectious diseases at Ramón y Cajal University Hospital in Madrid, told Healio. “Particular attention should be paid to those with comorbidities or low CD4 cell counts who might have a higher rate of COVID-19 or worse outcomes.”
Vizcarra and colleagues performed an observational prospective study of 51 patients with HIV with suspected or confirmed COVID-19 who were admitted to a single hospital in Madrid. They compared clinical characteristics of patients with COVID-19 and HIV with those of 1,288 patients with HIV who did not have COVID-19 and were analyzed before the pandemic.
A total of 69% of coinfection cases were in patients with lab-confirmed COVID-19, 55% of whom required hospital admission. CD4 counts were similar in both groups, but 63% of patients with COVID-19 and HIV had at least one comorbidity compared with 38% of patients without COVID-19.
A total of 12% of patients were critically ill, two had CD4 counts below 200 cells per L and 4% died.
“Our results support the idea that PLWH have a similar COVID-19 infection rate as the general population,” Vizcarra noted. “Furthermore, clinical, laboratory and radiographical features were comparable to those reported in noninfected individuals. Therefore, PLWH should receive a similar treatment approach.”
Vizcarra emphasized the need for more research and noted several limitations of the study.
“Although we included all PLWH diagnosed with COVID-19 at the time of the analysis, we still reported a small number of patients, limiting the generalizability of the results,” she said. “Moreover, local recommendations restricted the use of confirmatory tests to people with admission criteria, which could have biased the rate of COVID-19 diagnosis. Further multicenter studies with seroprevalence data would elucidate our results.”