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Amplifying and Quantifying HIV-1 RNA in HIV Infected Individuals with Viral Loads Below the Limit of Detection by Standard Clinical Assays
Published on: September 26, 2011
COVID-19 Breakthrough Infections Among People With HIV: A Statewide Cohort Analysis.
Xueying Yang1,2, Jiajia Zhang1,3, Shujie Chen1,3
1South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC.
COVID-19 breakthrough infections were common in people with HIV (PWH), especially during the Delta and Omicron variants. Booster doses significantly reduced breakthrough infections in this population.
Area of Science:
- Immunology
- Infectious Diseases
- Public Health
Background:
- People with HIV (PWH) may have altered immune responses.
- Understanding COVID-19 breakthrough infections in PWH is crucial for pandemic management.
Purpose of the Study:
- To determine the incidence of COVID-19 breakthrough infections in people with HIV (PWH).
- To investigate associations between immune status and breakthrough infections across pandemic phases.
Main Methods:
- Retrospective cohort study using electronic health records from South Carolina.
- Defined breakthrough infection as COVID-19 diagnosis post-full vaccination.
- Analyzed risk factors using Cox proportional hazards models.
Main Results:
- High incidence of breakthrough infections (118.95 per 1000 person-years) in fully vaccinated PWH.
- Increased risk during Delta (HR: 1.50) and Omicron (HR: 2.86) periods compared to Alpha.
- Booster doses significantly reduced breakthrough risk (HR: 0.19).
- Higher CD4 counts associated with fewer breakthroughs (HR: 0.68 for >500 vs <200 cells/mm³).
Conclusions:
- COVID-19 breakthrough infections are a significant concern for people with HIV (PWH).
- Absence of booster doses, older age, comorbidities, and low CD4 counts are key risk factors.
- Vaccination strategies should prioritize boosters for PWH, especially older individuals with comorbidities.
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