IMPACT of TENOFOVIR on SARS-CoV-2 INFECTION among PEOPLE LIVING with HIV

Background: The impact of some antiretrovirals against SARS-CoV-2 infection and disease severity is conflicting. We evaluated the effect of tenofovir alafenamide/emtricitabine (TAF/FTC) and tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) against SARS-CoV-2 infection and associated clinical outcomes among people living with (PLWH). Methods: We conducted a propensity score-matched analysis leveraging data from the PISCIS cohort of PLWH in Catalonia (Spain). We matched for TAF/FTC versus ABC/3TC in a ratio of 1:1, and 1:3 for TDF/FTC versus ABC/3TC, and TDF/FTC versus TAF/FTC. We used logistic regression to assess the association between tenofovir-based ART and SARS-CoV-2 diagnosis and associated hospitalisation. Results: In our entire cohort [median age: 46.1 years, 82.3% males], 7550 PLWH were being treated with TAF/FTC, 1020 receiving TDF/FTC, and 4135 receiving ABC/3TC. After propensity score-matching, SARS-CoV-2 diagnosis rates were the same in TAF/FTC versus ABC/3TC recipients (12.2% vs 12.2%, P=1.00);lower among TDF/FTC versus ABC/3TC recipients (9.7% vs 12.4%, P=0.05) with borderline significance;and lower among TDF/FTC versus TAF/FTC recipients (9.7% vs 12.6%, P=0.03). In well-adjusted logistic regression models, TAF/FTC was not associated with reduced SARS-CoV-2 diagnosis (adjusted odds ratio [aOR] 0.97;95% confidence interval [CI], 0.83-1.12) or associated hospitalisation (aOR 0.95;95% CI, 0.62-1.45). TDF/FTC compared to ABC/3TC, was not associated with reduced SARS-CoV-2 diagnosis (aOR 0.81;95% CI, 0.61-1.07) or hospitalisation (aOR 0.49;95% CI, 0.14-1.27). TDF/FTC was not associated with reduced SARS-CoV-2 diagnosis (aOR 0.81;95% CI, 0.61-1.07) or associated hospitalisation (aOR 0.47;95% CI, 0.14-1.22) compared to TAF/FTC. Conclusion: TAF/FTC or TDF/FTC were not associated with reduced SARS-CoV-2 diagnosis rates or associated hospitalisations among PLWH. TDF/FTC users had baseline characteristics intrinsically associated with more benign SARS-CoV-2 infection outcomes. Tenofovir exposure or not should not modify the preventive or therapeutic SARS-CoV-2 infection management.

HIV and SARS-CoV-2 Co-infection: Epidemiological, Clinical Features, and Future Implications for Clinical Care and Public Health for People Living with HIV (PLWH) and HIV Most-at-Risk Groups.

PURPOSE OF REVIEW: The purpose of this review is to use the currently available clinical and epidemiological data, to identify key aspects to improve both the clinical management and public health response to SARS-CoV-2/HIV co-infection among HIV vulnerable populations and people living with HIV (PLWH). RECENT FINDINGS: While at the beginning of the COVID-19 pandemic, the lack of robust information on SARS-CoV-2/HIV co-infection, prevented a clear picture of the synergies between them, currently available data strongly support the importance of common structural factors on both the acquisition and clinical impact of these infections and the relevance of age, comorbidities, and detectable HIV viral load as associated worse prognostic factors among PLWH. Although more information is needed to better understand the biological, clinical, and epidemiological relationship between both infections, a syndemic approach to prevent SARS-CoV-2 among HIV high-risk groups and PLWH, targeting these populations for SARS-CoV-2 vaccines and protocolizing early identification of PLWH with worse COVID-19 prognosis factors, is crucial strategies to decrease the overall impact of SARS-CoV-2 /HIV co-infection.

Community-based hbv screening increases linkage to care among west african migrants in greater barcelona, spain: Preliminary data from the hbvcomsava model of care

Background: African migrant populations living in Europe are disproportionately affected by HBV infection. Chronic HBV infection is a major public health threat for African migrant populations living in Spain who use health services at lower rates due to structural and/or cultural/linguistic barriers. Efforts to scale up prevention, testing and treatment are needed to reach the 2030 hepatitis elimination targets set by the WHO. TheHBV-COMSAVA study aims to use pointof-care testing and simplified diagnostic tools in community settings to identify and link to care or vaccinate west African migrants in the greater Barcelona area during the ongoing COVID-19 pandemic. Methods: 280 study participants were offered HBV screening in a pop-up clinic in a community setting from 21/11/20- 6/6/21 Rapid tests to screen for the presence of HBsAg were used and a blood sample was collected using plasma separation cards and analyzed in a laboratory. Patients received their results during a second visit and were offered: a) linkage to specialist care);b) posttest counselling;or c) vaccination of the first dose of the HBV vaccine in situ. Sociodemographic and clinical history were collected and basic standard descriptive statistics were utilized using STATA software. Participants who did not already have Catalonia's CatSalut health card were offered an expedited processing system to acquire one. Results: Five participants were excluded and 275 were included for analysis. The overall HBsAg prevalence was 12.7% (n=35). Of those included, laboratory results are available for 229 (83.3%). Of these, anti-HBc positivity was detected in 31.9% (n=73). The majority (44.4%, n=122) required vaccination against HBV followed by post-test counselling (30.9%, n=85) and referral to a specialist (12.7%, n=35). Of those who received their results (n=243), 75.7% returned and either received post-test counselling, linkage to specialist care, or the first dose of the HBV vaccine (figure 1). The HBV vaccination acceptance rate was 86.4%. Eight participants did not have access to the public health system and requested CatSalut cards and all were provided with one Conclusion: Despite the COVID-19 pandemic, by employing a community-based model of care utilizing novel simplified diagnostic tools the HBV-COMSAVA study demonstrated the possibility to screen, diagnose, link to care, and vaccinate African migrants who may otherwise not have received care.