HIV disease metrics and COVID-19 infection severity and outcomes in people living with HIV in central and eastern Europe
Language English Country England, Great Britain Media print-electronic
Document type Observational Study, Journal Article
PubMed
38014768
DOI
10.1111/hiv.13578
Knihovny.cz E-resources
- Keywords
- CD4 cell count, COVID-19, HIV viral load strata, PLWH, outcomes,
- MeSH
- COVID-19 * epidemiology complications MeSH
- HIV Infections * complications drug therapy epidemiology MeSH
- Humans MeSH
- CD4 Lymphocyte Count MeSH
- Respiratory Insufficiency * MeSH
- Retrospective Studies MeSH
- SARS-CoV-2 MeSH
- COVID-19 Testing MeSH
- Viral Load MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Observational Study MeSH
- Geographicals
- Europe, Eastern MeSH
BACKGROUND: To date there remains much ambiguity in the literature regarding the immunological interplay between SARS-CoV-2 and HIV and the true risk posed to coinfected individuals. There has been little conclusive data regarding the use of CD4 cell count and HIV viral load stratification as predictors of COVID-19 severity in this cohort. METHODS: We performed a retrospective, observational cohort study on people living with HIV (PLWH) who contracted COVID-19 in central and eastern Europe. We enrolled 536 patients from 16 countries using an online survey. We evaluated patient demographics, HIV characteristics and COVID-19 presentation and outcomes. Statistical analysis was performed using SPSS 20.1. RESULTS: The majority of the study cohort were male (76.4%) and 152 (28.3%) had a significant medical comorbidity. Median CD4 cell count at COVID-19 diagnosis was 605 cells/μL [interquartile range (IQR) 409-824]. The majority of patients on antiretroviral therapy (ART) were virally suppressed (92%). In univariate analysis, CD4 cell count <350 cells/μL was associated with higher rates of hospitalization (p < 0.0001) and respiratory failure (p < 0.0001). Univariate and multivariate analyses found that an undetectable HIV VL was associated with a lower rate of hospitalization (p < 0.0001), respiratory failure (p < 0.0001), ICU admission or death (p < 0.0001), and with a higher chance of full recovery (p < 0.0001). CONCLUSION: We can conclude that detectable HIV viral load was an independent risk factor for severe COVID-19 illness and can be used as a prognostic indicator in this cohort.
Carol Davila University for Medicine and Pharmacy Bucharest Romania
Charles University Faculty of Medicine in Plzeň University Hospital Plzeň Plzen Czech Republic
Department of Adults' Infectious Diseases Medical University of Warsaw Warsaw Poland
Department of Medicine Galway University Hospital Galway Ireland
Infectious Diseases AIDS and Clinical Immunology Center Tbilisi Georgia
Tartu University Hospital Tartu Estonia
University Hospital Center of Tirana Infectious Disease Service Tirana Albania
University Hospital for Infectious Diseases University of Zagreb School of Medicine Zagreb Croatia
Victor Babes Clinical Hospital for Infectious and Tropical Diseases Bucharest Romania
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