HIV status is not associated with SARS-CoV-2 viral load and longer duration of infection among people with well-controlled HIV and high COVID-19 vaccine coverage

Abstract

Objectives: This cohort study examined the associations between HIV status with SARS-CoV-2 viral load and duration of infection in a setting with high antiretroviral therapy (ART) coverage.

Methods: COVID-19 patients enrolled from public health clinics in Gaborone, Botswana underwent weekly serial testing for SARS-CoV-2. RT-PCR cycle threshold (Ct) value was used as a proxy measure of viral load. Multiple linear regression and Cox proportional-hazards models were used to determine the associations between HIV with Ct and time to SARS-CoV-2 negativity, respectively.

Results: Of the 486 enrolled participants, 88.7% were vaccinated for COVID-19, and 26.1% were people living with HIV (PLWH) with a mean CD4+ T cell count of 715 cells/µL and 86.6% taking ARTs. Mean Ct values were similar across HIV and CD4+ T cell categories (p = 0.76). Time to negativity was similar for PLWH with CD4+ T cell count ≥500 cells/uL (adjusted hazard ratio [aHR] = 1.00; 95% confidence interval [CI] = 0.61, 1.64) and <500 cells/uL (aHR = 1.24; 95% CI = 0.88, 1.75) compared to people without HIV.

Conclusions: In a setting with well-controlled HIV and high COVID-19 vaccine coverage, HIV status was not associated with SARS-CoV-2 viral load or infection duration.

Keywords: CD4 cell count; COVID-19; HIV/AIDS; Human Immunodeficiency Virus; SARS-CoV-2; chronic infection; cycle threshold value; immunosuppression; transmission; viral shedding.