人类免疫缺陷病毒感染者中SARS-CoV-2感染和严重结果的危险因素:队列研究
John J Hanna1,2, Liyu B Geresu2,3, Marlon I Diaz2
1Division of Infectious Diseases and Geographic Medicine, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Open forum infectious diseases
|August 14, 2023
概括
这项研究发现,虽然COVID-19 (SARS-CoV-2) 不成比例地影响了某些艾滋病毒感染者群体 (PWH),但严重的结果与共患病和艾滋病毒管理不善有关,而不仅仅是病毒本身.
科学领域:
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
- 免疫学 免疫学 免疫学
背景情况:
- 关于艾滋病毒感染者 (PWH) 的COVID-19 (SARS-CoV-2) 结果存在有限的研究.
- 需要进一步的研究来确定PWH中SARS-CoV-2感染的风险因素和结果.
研究的目的:
- 调查与PWH中SARS-CoV-2阳性相关的因素.
- 为了确定PWH中严重的COVID-19结局的风险因素.
- 检查影响严重结果的HIV特定变量.
主要方法:
- 使用国家OPTUM COVID-19数据集进行回顾性队列研究.
- 分析与SARS-CoV-2阳性和严重结果相关的因素.
- 多变量逻辑回归以调整共变量.
- 艾滋病毒特定变量的子组分析.
主要成果:
- 年龄较小,西班牙裔白人和非裔美国人种族,美国南部的居住地,缺乏保险,不经常吸烟,更高的BMI和更高的查尔森并发症指数与PWH中的SARS-CoV-2阳性有关.
- 在PWH中严重的结果与SARS-CoV-2阳性,年龄较大,美国南部居住,医疗补助/医疗保险或无保险状态,目前吸烟,体重不足状态和较高的查尔森并发症指数有关.
- 在具有艾滋病毒治疗数据的PWH中,未抑制的艾滋病毒病毒载量,低CD4计数和没有抗逆转录病毒治疗与严重结局的更高几率有关.
结论:
- 在PWH中存在SARS-CoV-2感染的显著种族,种族和地理差异.
- 慢性并发病,老年,较低的BMI和吸烟与PWH中严重的COVID-19结局有关.
- 虽然SARS-CoV-2感染与严重的结果有关,但HIV管理不良 (CD4计数低,病毒载量高,没有ART) 是PWH中严重结果的更强有力的预测因素.
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