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SARS-CoV-2 incidence, testing rates, and severe COVID-19 outcomes among people with and without HIV

Matthew A Spinelli1, Lillian B Brown1, David V Glidden2

  • 1Division of HIV, ID, and Global Medicine.

AIDS (London, England)
|December 6, 2021
PubMed

Insights

People with HIV (PWH) face a higher risk of severe COVID-19, despite lower SARS-CoV-2 incidence. Prioritizing HIV-positive individuals for vaccination is crucial to prevent severe outcomes.

Area of Science:

  • Infectious Diseases
  • Public Health
  • HIV Medicine

Background:

  • Understanding SARS-CoV-2 outcomes in vulnerable populations is critical.
  • People with HIV (PWH) represent a key group for assessing differential disease impact.

Purpose of the Study:

  • To evaluate clinical outcomes of SARS-CoV-2 infection stratified by HIV status.
  • To determine the risk of severe COVID-19 among PWH compared to the general population.

Main Methods:

  • Matched municipal COVID-19 registry data with clinic rosters from a primary care network.
  • Included a large clinic serving people with HIV.
  • Assessed clinical outcomes based on HIV status.

Main Results:

  • People with HIV (PWH) exhibited a significantly higher risk of severe COVID-19 (aRR=1.84, 95% CI=1.05-3.25).
  • Despite higher testing rates, SARS-CoV-2 incidence was lower among PWH.
  • Higher testing rates in PWH did not translate to higher incidence.

Conclusions:

  • PWH are at an elevated risk for severe COVID-19.
  • SARS-CoV-2 vaccination campaigns should prioritize PWH to mitigate severe disease.
  • Public health strategies must consider the heightened vulnerability of PWH to COVID-19 complications.

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