Comorbidities in people living with HIV in the north east who are unvaccinated against COVID-19: a descriptive study

ABSTRACT

Background: People living with HIV (PLWH) are at increased risk of severe or critical COVID-19. This is in addition to the increased risk associated with any coexisting conditions such as chronic pulmonary disease (CPD), chronic kidney disease and cardiovascular disease. Vaccination against COVID-19 is therefore strongly recommended for PLWH. Method(s) We conducted a descriptive study to evaluate comorbidities among PLWH attending for HIV care at two NHS Trusts in North East England and who were under- or unvaccinated against COVID-19, defined as having received either zero or 1 doses of any COVID-19 vaccine by 01/10/2022. PLWH under active care were identified using the HIV and AIDS Reporting System (HARS) dataset. Vaccination data were obtained from regional integrated care records (RICR) and cross-referenced with HARS. Information on comorbidities was collated for any patients who were under- or unvaccinated. To quantify risk and clinical vulnerability, we calculated the Charlson Comorbidity Index (CCI) for each of these patients. A CCI score >=1 is associated with mortality/poor outcomes in patients with COVID-19. Result(s) 141 under- or unvaccinated patients were identified out of a total cohort of 1492 patients who attended for HIV care (9.5%);of these, 96 (68.1%) and 45 (31.9%) had received zero and one vaccination respectively. The median age of this under-/unvaccinated cohort was 41 years and 91 (64.5%) were male. 62 patients (44.0%) had a CCI score of 1 or more;13 patients (9.2%) had a diagnosis of AIDS during the time period evaluated;11 (84.6%) of the patients with an AIDS diagnosis were completely unvaccinated. Non-HIV comorbidities included liver disease (10/141, 7.1%), solid organ cancer (5/141, 3.5%), CPD (4/141, 2.8%) and connective tissue disease (3/141, 2.1%). Six patients (4.3%) had >=2 comorbidities. Conclusion(s) Nearly half of the under-/unvaccinated PLWH attending our services were identified as being at an increased risk of having a poor outcome in the event of contracting COVID-19. Proactively identifying these individuals would allow services to offer tailored support in making informed decisions about vaccinations. Useful strategies may include the use of patient information leaflets and targeted discussion with patients explaining their individual risk from COVID-19.