Risk of adverse coronavirus disease 2019 outcomes for people living with HIV.
AIDS
; 35(4): F1-F10, 2021 03 15.
Article
in English
| MEDLINE | ID: covidwho-1135927
ABSTRACT
OBJECTIVE:
To assess whether people living with HIV (PLWH) are at increased risk of coronavirus disease 2019 (COVID-19) mortality or adverse outcomes, and whether antiretroviral therapy (ART) influences this risk.DESIGN:
Rapid review with meta-analysis and narrative synthesis.METHODS:
We searched databases including Embase, Medline, medRxiv and Google Scholar up to 26 August 2020 for studies describing COVID-19 outcomes in PLWH and conducted a meta-analysis of higher quality studies.RESULTS:
We identified 1908 studies and included 19 in the review. In a meta-analysis of five studies, PLWH had a higher risk of COVID-19 mortality [hazard ratio 1.95, 95% confidence interval (CI) 1.62-2.34] compared with people without HIV. Risk of death remained elevated for PLWH in a subgroup analysis of hospitalized cohorts (hazard ratio 1.60, 95% CI 1.12-2.27) and studies of PLWH across all settings (hazard ratio 2.08, 95% CI 1.69-2.56). Eight other studies assessed the association between HIV and COVID-19 outcomes, but provided inconclusive, lower quality evidence due to potential confounding and selection bias. There were insufficient data on the effect of CD4+ T-cell count and HIV viral load on COVID-19 outcomes. Eleven studies reported COVID-19 outcomes by ART-regimen. In the two largest studies, tenofovir disoproxil fumarate-based regimens were associated with a lower risk of adverse COVID-19 outcomes, although these analyses are susceptible to confounding by co-morbidities.CONCLUSION:
Emerging evidence suggests a moderately increased risk of COVID-19 mortality among PLWH. Further investigation into the relationship between COVID-19 outcomes and CD4+ T-cell count, HIV viral load, ART and the use of tenofovir disoproxil fumarate is warranted.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
HIV Infections
/
Tenofovir
/
COVID-19
Type of study:
Cohort study
/
Observational study
/
Prognostic study
/
Reviews
Topics:
Long Covid
/
Variants
Limits:
Humans
Language:
English
Journal:
AIDS
Journal subject:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Year:
2021
Document Type:
Article
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