Effects of HIV status and vaccination on long COVID conditions within an integrated health care system

COVID infection has been linked to long-term effects known as Long COVID Conditions (PCC), presenting within 30-120 days post-acute COVID infection. Few studies have focused on PCC incidence among people with HIV (PLWH). Additionally, the effect of vaccination, especially among PLWH, is unclear on the risk for PCC. We evaluate PCC incidence among PLWH compared with people without HIV (PWoH), as well as the effect of COVID vaccination, within an integrated closed healthcare system with high ascertainment of COVID-19 testing.

Adult patients with a positive polymerase chain reaction test for COVID between 1/1/2020-1/31/2022 were matched PLWH to PWoH by month of test, age, race, sex, vaccination status, using 1:3 variable ratio matching. PCC was defined as presenting with at least one of 17 previously identified conditions incident in the 30-120 days post first positive test date. We determined the effect of COVID vaccination on subsequent development of PCC using an unmatched PLWH/PWoH population analyzed by multivariate regression modeling.

We show that 749 PLWH matched to 2,236 PWoH for PCC incidence evaluation and 492 (PLWH) and 71,844 PWoH for vaccination analysis. PLWH have 25% higher risk of PCC than PWoH. Gastrointestinal and other nervous system disorders are significantly higher among PLWH. Vaccination has significant impact on acute-persistent PCC risk but not late incident PCC without impact by HIV status.

PLWH have higher risk of PCC. Vaccination lowers persistent symptom risk, but not late incident PCC risk. Vaccination and vigilance for PCC is encouraged.