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Risk factors for progressing to severe COVID-19 among people living with HIV in Japan: A hospital claims database

Akio Kanazawa1, Yan Yan1, Mayumi Yuda2

  • 1Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan.

Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy
|September 14, 2023
PubMed

Insights

Older age and hypertension increase severe COVID-19 risk in people living with HIV (PLWH) in Japan. AIDS diagnosis was not a significant risk factor for adverse outcomes in this study population.

Area of Science:

  • Infectious Diseases
  • Public Health
  • Clinical Medicine

Background:

  • Limited data exists on severe COVID-19 risk factors for people living with HIV (PLWH) in Japan.
  • Understanding these factors is crucial for managing COVID-19 in this vulnerable population.

Purpose of the Study:

  • To investigate the association between AIDS diagnosis, comorbidities, and severe COVID-19 outcomes in hospitalized PLWH in Japan.
  • To identify specific risk factors that predict adverse COVID-19 progression among PLWH.

Main Methods:

  • Retrospective observational study using Diagnosis Procedure Combination (DPC) system data from January 2020 to December 2021.
  • Analyzed clinical outcomes of 85 adult PLWH hospitalized with COVID-19 who were receiving antiretroviral therapy.
  • Assessed associations between AIDS diagnosis, comorbidities (e.g., hypertension), and COVID-19 severity (mild/moderate vs. severe/death).

Main Results:

  • Of 85 PLWH, 91.8% were male, with a mean age of 48 years. Most (88.2%) had mild/moderate COVID-19; 10.6% had severe disease, and 1.2% died.
  • Older age (p=0.002) and hypertension (p=0.032) were significantly associated with severe COVID-19 or death.
  • AIDS diagnosis and other AIDS-defining illnesses were not found to be significant risk factors for severe outcomes in this cohort.

Conclusions:

  • In Japan, older PLWH and those with hypertension face an elevated risk of severe COVID-19 outcomes.
  • These findings suggest the need for close clinical monitoring of older PLWH and those with hypertension during COVID-19 infection.
  • While AIDS itself was not a significant predictor, comorbidities and age remain critical factors in COVID-19 severity for PLWH.
Abstract

Keywords:
AIDSARTCOVID-19CancerJapanPeople living with HIV (PLWH)

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