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Review
. 2022 Oct;19(5):425-432.
doi: 10.1007/s11904-022-00618-w. Epub 2022 Aug 5.

COVID-19 Outcomes and Risk Factors Among People Living with HIV

Matthew A Spinelli  1 , Benjamin L H Jones  2 , Monica Gandhi  3
Affiliations
Review

COVID-19 Outcomes and Risk Factors Among People Living with HIV

Matthew A Spinelli et al. Curr HIV/AIDS Rep. 2022 Oct.

Abstract

Purpose of review: In this review, we examine the intersection of the HIV and COVID-19 epidemics with focus on COVID-19-related health outcomes and risk factors for SARS-CoV-2 among people living with HIV (PLWH).

Recent findings: Evidence to date do not suggest a higher incidence of SARS-CoV-2 infection among PLWH compared to the general population, although-once exposed-PLWH are at greater risk of severe COVID-19 outcomes. Key risk factors for severe COVID-19 include non-HIV comorbidities known to be associated with severe disease, as well as HIV-specific risk factors such as low CD4 + T-cell count, unsuppressed viral load, and tuberculosis co-infection. The disproportionate impact of the SARS-CoV-2 pandemic among Black, Latinx, and Native American/Alaskan Native PLWH could worsen pre-existing disparities in health outcomes among PLWH. Data on SARS-CoV-2 vaccine protection among PLWH needs additional study, although some studies suggest decreased humoral responses among those with low CD4 + T-cell counts, while there is a signal of increased vaccine breakthrough rates among PLWH in two large observational cohorts. Data on post-acute sequelae of SARS-CoV-2 (PASC) among PLWH is also limited. PLWH do not have a higher susceptibility to SARS-CoV-2, but once exposed, they are at higher risk of severe COVID-19 outcomes. Additional resources will need to be dedicated to the development of interventions to improve health outcomes and address disparities among PLWH impacted by the COVID-19 pandemic.

Keywords: HIV; Health outcomes; PASC; SARS-CoV-2; Severe COVID-19; Vaccination.

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Conflict of interest statement

The authors declare no competing interests.

References

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