ABSTRACT
Background: We aimed to compare the epidemiological and clinical characteristics of coronavirus disease 2019 (COVID-19) in people living with human immunodeficiency virus (HIV) (PLWH) with those in the general population. Methods: This nationwide descriptive epidemiological study was conducted in South Korea between January 2020 and February 2022. The National Health Insurance claims data covering the whole nation were collected through the Health Insurance Review and Assessment Service. Results: Among 3,653,808 individuals who were diagnosed with COVID-19, 1,311 (0.04%) were PLWH. All the PLWH received antiretroviral therapy, and 26.47% had more than one underlying disease other than HIV infection. The overall in-hospital mortality rates of PLWH and the general population were 0.76% and 0.25%, respectively (P=0.002). According to the Cox proportional hazard model, no significant difference was observed in the in-hospital mortality rate [hazard ratio (HR): 1.80, 95% confidence interval (CI): 0.70–4.67] between PLWH and the general population. However, progression to severe or critical COVID-19 was more common in PLWH (HR: 2.70, 95% CI: 1.37–5.33). In PLWH diagnosed with COVID-19, a multivariable Cox regression analysis found old age (≥60 years old) (HR: 6.9; 95% CI 2.57–18.56) and diabetes mellitus (HR: 5.13; 95% CI: 2.02–13.00) as the independent risk factors for severe or critical COVID-19. Conclusions: PLWH had a significantly higher risk of severe or critical COVID-19 than that of the general population. Our findings suggest the need for applying differentiated strategies to decrease the impact of COVID-19 on PLWH.
Subject(s)
COVID-19 , Virus Diseases , HIV Infections , Diabetes MellitusABSTRACT
Messenger RNA (mRNA) vaccination has been implemented to mitigate the coronavirus disease 2019 pandemic. However, data on antibody kinetics and factors influencing mRNA vaccines’ immunogenicity are limited. We conducted a prospective study on healthy young adults who received two doses of the mRNA-1273 vaccine at 28-day intervals. After each dose, adverse events were prospectively evaluated and blood samples were collected. The correlation between humoral immune response and reactogenicity after vaccination was determined. In 177 participants (19–55 years), the geometric mean titers of the anti-S IgG antibody were 178.07 and 4409.61 U/mL, whereas those of 50% neutralizing titers were 479.95 and 2851.67 U/mL 4 weeks after the first and second doses, respectively. The anti-S IgG antibody titers were not associated with local reactogenicity, but they were significantly higher in participants who experienced systemic adverse events (fever, headache, and muscle pain). Antipyretic use was an independent predictive factor of strong anti-SARS-CoV-2 antibody response after receiving both doses. Systemic reactogenicity after the first dose influenced antibody response after the second dose. mRNA-1273 induced a robust antibody response in healthy young adults. Post-vaccination immunogenicity might be related to systemic reactogenicity. Antipyretic use did not decrease the anti-SARS-CoV-2 antibody response after mRNA-1273 vaccination. Funding: This work was supported by the Korea National Institute of Health, Korea Disease Control and Prevention Agency [2021ER260300].