Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2022 May 10:13:864838.
doi: 10.3389/fimmu.2022.864838. eCollection 2022.

Systematic Review and Meta-Analyses of The Interaction Between HIV Infection And COVID-19: Two Years' Evidence Summary

Yehua Wang  1 , Yewei Xie  2   3   4 , Siyue Hu  4 , Wei Ai  5 , Yusha Tao  4 , Huilin Tang  1 , Fengshi Jing  3   4 , Weiming Tang  3   4   6
Affiliations
Meta-Analysis

Systematic Review and Meta-Analyses of The Interaction Between HIV Infection And COVID-19: Two Years' Evidence Summary

Yehua Wang et al. Front Immunol. .

Abstract

Introduction: During the COVID-19 pandemic, people living with HIV (PLWH) were considered to be at risk of worse COVID-19 outcomes once infected. However, the existing evidence is inconsistent. This systematic review and meta-analysis aimed to compare the risk of SARS-CoV-2 infection, severe COVID-19 symptoms, and mortality among PLWH and patients without HIV.

Method: The articles included studies published in PubMed, Medline, Embase, and Cochrane between December 1, 2019, and December 1, 2021. We included the original studies published in English focusing on observational studies assessing the risk of SARS-CoV-2 infection, severe COVID-19 symptoms, and mortality among PLWH. Four independent reviewers extracted data. STrengthening the Reporting of OBservational studies in Epidemiology-Modified (STROBE-M) checklist was used for quality assessment. For the results with heterogeneity I2 >75%, a random-effects model was employed. Otherwise, a fixed-effects model was used. The risk of SARS-CoV-2 infection, severe COVID-19 symptoms, and mortality were compared with and without HIV.

Results: We included a total of 32 studies and 71,779,737 study samples, of whom 797,564 (1.11%) were PLWH. Compared with COVID-19 patients without HIV infection, PLWH had comparable risk of SARS-CoV-2 infection (adjusted Risk Ratio=1.07, 95% CI: 0.53-2.16, I2 = 96%, study n=6, n=20,199,805) and risk of developing severe COVID-19 symptoms (aRR=1.06, 95% CI: 0.97-1.16, I2 = 75%, n=10, n=2,243,370). PLWH, if infected with SARS-CoV-2, were found to have an increased risk of mortality compared with people without HIV (aRR=1.30, 95% CI: 1.09-1.56, I2 = 76%, study n=16, n=71,032,659). This finding was consistent across different subgroup analyses.

Conclusion: PLWH are at increased risk of COVID-19 related mortality once infected. The local health system should, on the one hand, strengthen COVID-19 prevention and clinical management among PLWH to avoid infection and, on the other hand, sustain the HIV care continuum for PLWH for HIV management.

Keywords: Coronavirus-19 (COVID-19); SARS-CoV-2; human immunodeficiency virus (HIV); meta-analysis; systematic review.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The handling editor declared a shared affiliation with the authors YX, FJ, WT at the time of review.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) chart for the literature search.
Figure 2
Figure 2
The forest plot of the crude risk ratio of SARS-CoV-2 infection, Severe COVID-19 symptoms, and COVID-19 mortality, comparing the patients with and without HIV.
Figure 3
Figure 3
The forest plot of the adjusted risk ratio of SARS-CoV-2 infection, Severe COVID-19 symptoms, and COVID-19 mortality, comparing the patients with and without HIV.
See this image and copyright information in PMC

References

    1. European Centre for Disease Prevention and Control . Timeline of ECDC's Response to COVID-19. Available at: https://www.ecdc.europa.eu/en/covid-19/timeline-ecdc-response (Accessed January 27, 2022).
    1. WHO . Coronavirus Disease (COVID-19) Weekly Epidemiological Update and Weekly Operational Update. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situatio... (Accessed January 27, 2022).
    1. Zhang H, Wu T. CD4+T, Cd8+T Counts and Severe COVID-19: A Meta-Analysis. J Infect Dis (2020) 81(3):e82–4. doi: 10.1016/j.jinf.2020.06.036 - DOI - PMC - PubMed
    1. Ho HE, Peluso MJ, Margus C, Matias Lopes JP, He C, Gaisa MM, et al. . Clinical Outcomes and Immunologic Characteristics of Coronavirus Disease 2019 in People With Human Immunodeficiency Virus. J Infect Dis (2021) 223(3):403–8. doi: 10.1093/infdis/jiaa380 - DOI - PMC - PubMed
    1. UNAIDS . Global HIV & AIDS Statistics — 2020 Fact Sheet. Available at: https://www.unaids.org/en/resources/fact-sheet (Accessed January 27, 2022).

Publication types