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Meta-Analysis Confirms Higher COVID Death Risk With HIV
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AIDS 2022, July 29-August 2, Montreal
Mark Mascolini
Once infected with SARS-CoV-2, people with HIV run a 30% higher risk of COVID-related death, according to a 32-study meta-analysis [1]. But people with HIV did not have a higher risk of infection with SARS-CoV-2 or a higher risk of severe COVID symptoms after infection than people without HIV.
Evidence on the risk of worse COVID outcomes with HIV has been inconsistent. To clarify the relative impact of COVID on people with HIV, collaborators in the US and China conducted a systematic review and meta-analysis of relevant studies. They searched for HIV-COVID studies in the PubMed, Medline, Embase, and Cochrane databases that appeared between December 1, 2019, and December 1, 2021. Articles had to be original observational studies published in English, include people with and without HIV, and address at least one of three outcomes: risk of SARS-CoV-2 infection, risk of severe COVID symptoms, and risk of COVID-related mortality.
The investigators turned up 2225 articles that met their inclusion criteria. Screening and analysis winnowed that sample to 32 studies including 71.8 million study samples, of which 797,564 (1.1%) represented people with HIV. They judged two studies to be excellent in quality, 15 to have good quality, 13 to have fair quality, and 2 to have poor quality.
Meta-analysis determined that, compared with HIV-negative COVID patients, the HIV-positive COVID group had a comparable risk of SARS-CoV-2 infection (adjusted relative risk [aRR] 1.07, 95% confidence interval [CI] 0.53 to 2.16). Compared with the HIV-negative COVID cluster, COVID patients with HIV had a similar risk of severe COVID symptoms (aRR 1.06, 95% CI 0.97 to 1.16).
But people with HIV had a significantly greater risk of COVID-related death than the non-HIV group (aRR 1.30, 95% CI 1.09 to 1.56). This finding proved consistent over various subgroup analyses.
The authors recommended that local health authorities strengthen COVID prevention and management in people with HIV infection while sustaining the care continuum for people with HIV.
Reference
1. Wang Y, Xie Y, Hu S, et al. Systematic review and meta-analyses of the interaction between HIV infection and COVID-19: two years' evidence summary. AIDS 2022, July 29-August 2, Montreal. Abstract EPC080.
CONCLUSION
PLWH are at increased risk of COVID-19 related mortality once infected.
The local health system should, on the one hand, strengthen COVID-19 prevention & management among PLWH to avoid infection, and, on the other hand, sustain the HIV care continuum for PLWH for HIV management.
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