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. 2022 Jan 1;89(1):1-8.
doi: 10.1097/QAI.0000000000002822.

SARS-CoV-2 Infection Among People Living With HIV Compared With People Without HIV: Survey Results From the MACS-WIHS Combined Cohort Study

Gypsyamber D'Souza  1 , Weiqun Tong  1 , Deborah Gustafson  2 , Maria L Alcaide  3 , Cecile D Lahiri  4 , Anjali Sharma  5 , Audrey L French  6 , Frank J Palella  7 , Mirjam-Colette Kempf  8 , Matthew J Mimiaga  9 , Catalina Ramirez  10 , Seble Kassaye  11 , Charles R Rinaldo  12 , Todd T Brown  13 , Phyllis C Tien  14 , Adaora A Adimora  15
Affiliations

SARS-CoV-2 Infection Among People Living With HIV Compared With People Without HIV: Survey Results From the MACS-WIHS Combined Cohort Study

Gypsyamber D'Souza et al. J Acquir Immune Defic Syndr. .

Abstract

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19) symptoms among people living with HIV (PLWH) are not well described.

Setting: Longitudinal survey within the MACS/WIHS Combined Cohort Study (MWCCS) of PLWH compared with similar HIV-seronegative (SN) individuals.

Methods: Telephone-administered survey of MWCCS participants at 13 clinical research sites across the United States addressing COVID-19 symptoms, SARS-CoV-2 testing, and pandemic impact on social distancing and antiretroviral therapy (ART) use. Primary data collection occurred during May (wave 1), June-July (wave 2), and August-September, 2020 (wave 3).

Results: One-third of MWCCS participants were tested for SARS-CoV-2 infection; 10% was tested ≥2 times. Similar proportions of PLWH and SN participants were tested, but SARS-CoV-2 positivity was higher among PLWH than among SN individuals (9.4% vs 4.8%, P = 0.003). Odds of SARS-CoV-2 positivity remained higher among PLWH after adjusting for age, sex, race/ethnicity, and study site (adjusted odds ratio = 2.0, 95% confidence interval = 1.2 to 3.2). SARS-CoV-2 positivity was not associated with CD4 cell counts among PLWH. Among SARS-CoV-2 positive participants, 9% had no symptoms, 7% had 1-2 mild symptoms, and 84% had ≥3 symptoms. Most of the (98%) participants reported physical distancing during all survey waves; self-reported ART adherence among PLWH was not adversely affected during the pandemic compared with the previous year (similar adherence in 89% of participants, improved in 9% of participants, and decreased in 2% of participants).

Conclusions: Despite similar SARS-CoV-2 testing and physical distancing profiles by HIV serostatus among MWCCS participants, PLWH who reported SARS-CoV-2 testing were more likely to have a positive test result. Additional studies are needed to determine whether and why PLWH are at increased risk of SARS-CoV-2 infection.

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Conflict of interest statement

T.T.B. has served as a consultant for Merck, Gilead, Janssen, ViiV Healthcare, and Theratechnologies. F.J.P. has served as a consultant and/or speaker for Merck, Gilead, Janssen, ViiV Healthcare, and Theratechnologies. The remaining authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
SARS-CoV-2 test positivity by HIV serostatus and most recent CD4 cell count, among persons tested for SARS-CoV-2.
Figure 2.
Figure 2.
Percent of positive SARS-CoV-2 tests among persons tested by study site region and HIV serostatus
See this image and copyright information in PMC

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