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Asymptomatic SARS-CoV-2 Infection Is Common Among ART-Treated People With HIV.

Edgar T Overton1, Isabelle R Weir2, Markella V Zanni3

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Journal of Acquired Immune Deficiency Syndromes (1999)
|April 12, 2022
PubMed
Summary
This summary is machine-generated.

Asymptomatic COVID-19 is common in people with HIV (PWH) on antiretroviral therapy, with 60% of infections showing no symptoms. HIV clinicians should prioritize COVID-19 testing in PWH to detect these silent infections.

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Area of Science:

  • Infectious Diseases
  • Virology
  • Public Health

Background:

  • Limited data exist on asymptomatic COVID-19 in people with HIV (PWH).
  • This study presents data from a representative subset of PWH in the global Randomized Trial to Prevent Vascular Events in HIV (iPrEDTA).

Purpose of the Study:

  • To investigate the prevalence and characteristics of asymptomatic SARS-CoV-2 infections among PWH.
  • To inform clinical practice regarding COVID-19 screening in this population.

Main Methods:

  • Data on COVID-19 diagnosis and symptoms were collected from PWH in the iPrEDTA trial (N=7770).
  • SARS-CoV-2 infection was defined by clinical diagnosis or antibody presence (IgG/IgA) in unvaccinated individuals.
  • Symptom status was assessed in infected PWH (N=304).

Main Results:

  • SARS-CoV-2 infection occurred in 13% (318/2464) of the studied PWH cohort.
  • 60% (183/304) of infected PWH were asymptomatic.
  • Asymptomatic infections were more common in individuals from low/middle-income regions, of Black or African American race, older age, and higher cardiovascular risk.
  • Symptomatic COVID-19 was associated with obesity, metabolic syndrome, and low HDL levels.
  • CD4 counts and HIV viral suppression did not differ between symptomatic and asymptomatic PWH.

Conclusions:

  • Asymptomatic SARS-CoV-2 infection is prevalent in PWH on antiretroviral therapy.
  • HIV clinicians need to maintain vigilance for COVID-19 testing in PWH to identify asymptomatic cases.
  • Understanding risk factors for asymptomatic infection can aid in targeted screening and management.