COVID‐19 vaccine effectiveness by HIV status and history of injection drug use: a test‐negative analysis
Abstract Introduction People living with HIV (PLWH) and/or who inject drugs may experience lower vaccine effectiveness (VE) against SARS‐CoV‐2 infection. Methods A validated algorithm was applied to population‐based, linked administrative datasets in the British Columbia COVID‐19 Cohort (BCC19C) to...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-10-01
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| Series: | Journal of the International AIDS Society |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jia2.26178 |
| _version_ | 1797646938528546816 |
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| author | Joseph H. Puyat James Wilton Adeleke Fowokan Naveed Zafar Janjua Jason Wong Troy Grennan Catharine Chambers Abigail Kroch Cecilia T. Costiniuk Curtis L. Cooper Darren Lauscher Monte Strong Ann N. Burchell Aslam Anis Hasina Samji COVAXHIV Study Team |
| author_facet | Joseph H. Puyat James Wilton Adeleke Fowokan Naveed Zafar Janjua Jason Wong Troy Grennan Catharine Chambers Abigail Kroch Cecilia T. Costiniuk Curtis L. Cooper Darren Lauscher Monte Strong Ann N. Burchell Aslam Anis Hasina Samji COVAXHIV Study Team |
| author_sort | Joseph H. Puyat |
| collection | DOAJ |
| description | Abstract Introduction People living with HIV (PLWH) and/or who inject drugs may experience lower vaccine effectiveness (VE) against SARS‐CoV‐2 infection. Methods A validated algorithm was applied to population‐based, linked administrative datasets in the British Columbia COVID‐19 Cohort (BCC19C) to ascertain HIV status and create a population of PLWH and matched HIV‐negative individuals. The study population was limited to individuals who received an RT‐PCR laboratory test for SARS‐CoV‐2 between 15 December 2020 and 21 November 2021 in BC, Canada. Any history of injection drug use (IDU) was ascertained using a validated administrative algorithm. We used a test‐negative study design (modified case−control analysis) and multivariable logistic regression to estimate adjusted VE by HIV status and history of IDU. Results Our analysis included 2700 PLWH and a matched population of 375,043 HIV‐negative individuals, among whom there were 351 and 103,049 SARS‐CoV‐2 cases, respectively. The proportion of people with IDU history was much higher among PLWH compared to HIV‐negative individuals (40.7% vs. 4.3%). Overall VE during the first 6 months after second dose was lower among PLWH with IDU history (65.8%, 95% CI = 43.5–79.3) than PLWH with no IDU history (80.3%, 95% CI = 62.7–89.6), and VE was particularly low at 4–6 months (42.4%, 95% CI = −17.8 to 71.8 with IDU history vs. 64.0%; 95% CI = 15.7–84.7 without), although confidence intervals were wide. In contrast, overall VE was 88.6% (95% CI = 88.2–89.0) in the matched HIV‐negative population with no history of IDU and remained relatively high at 4–6 months after second dose (84.6%, 95% CI = 83.8–85.4). Despite different patterns of vaccine protection by HIV status and IDU history, peak estimates were similar (≥88%) across all populations. Conclusions PLWH with a history of IDU may experience lower VE against COVID‐19 infection, although findings were limited by a small sample size. The lower VE at 4–6 months may have implications for booster dose prioritization for PLWH and people who inject drugs. The immunocompromising effect of HIV, substance use and/or co‐occurring comorbidities may partly explain these findings. |
| first_indexed | 2024-03-11T15:09:09Z |
| format | Article |
| id | doaj.art-b929a536b94d4319a87cddabaddc2f8d |
| institution | Directory Open Access Journal |
| issn | 1758-2652 |
| language | English |
| last_indexed | 2024-03-11T15:09:09Z |
| publishDate | 2023-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the International AIDS Society |
| spelling | doaj.art-b929a536b94d4319a87cddabaddc2f8d2023-10-30T01:48:29ZengWileyJournal of the International AIDS Society1758-26522023-10-012610n/an/a10.1002/jia2.26178COVID‐19 vaccine effectiveness by HIV status and history of injection drug use: a test‐negative analysisJoseph H. Puyat0James Wilton1Adeleke Fowokan2Naveed Zafar Janjua3Jason Wong4Troy Grennan5Catharine Chambers6Abigail Kroch7Cecilia T. Costiniuk8Curtis L. Cooper9Darren Lauscher10Monte Strong11Ann N. Burchell12Aslam Anis13Hasina Samji14COVAXHIV Study Team15British Columbia Centre for Disease Control Vancouver British Columbia CanadaBritish Columbia Centre for Disease Control Vancouver British Columbia CanadaBritish Columbia Centre for Disease Control Vancouver British Columbia CanadaBritish Columbia Centre for Disease Control Vancouver British Columbia CanadaBritish Columbia Centre for Disease Control Vancouver British Columbia CanadaBritish Columbia Centre for Disease Control Vancouver British Columbia CanadaDalla Lana School of Public Health University of Toronto Toronto Ontario CanadaThe Ontario HIV Treatment Network Toronto Ontario CanadaDivision of Infectious Diseases and Chronic Viral Illness Service Department of Medicine McGill University Health Centre Montreal Quebec CanadaDepartment of Medicine University of Ottawa Ottawa Ontario CanadaCIHR Canadian HIV Trials Network Vancouver British Columbia CanadaPacific AIDS Network Vancouver British Columbia CanadaDalla Lana School of Public Health University of Toronto Toronto Ontario CanadaSchool of Population and Public Health University of British Columbia Vancouver British Columbia CanadaBritish Columbia Centre for Disease Control Vancouver British Columbia CanadaBritish Columbia Centre for Disease Control Vancouver British Columbia CanadaAbstract Introduction People living with HIV (PLWH) and/or who inject drugs may experience lower vaccine effectiveness (VE) against SARS‐CoV‐2 infection. Methods A validated algorithm was applied to population‐based, linked administrative datasets in the British Columbia COVID‐19 Cohort (BCC19C) to ascertain HIV status and create a population of PLWH and matched HIV‐negative individuals. The study population was limited to individuals who received an RT‐PCR laboratory test for SARS‐CoV‐2 between 15 December 2020 and 21 November 2021 in BC, Canada. Any history of injection drug use (IDU) was ascertained using a validated administrative algorithm. We used a test‐negative study design (modified case−control analysis) and multivariable logistic regression to estimate adjusted VE by HIV status and history of IDU. Results Our analysis included 2700 PLWH and a matched population of 375,043 HIV‐negative individuals, among whom there were 351 and 103,049 SARS‐CoV‐2 cases, respectively. The proportion of people with IDU history was much higher among PLWH compared to HIV‐negative individuals (40.7% vs. 4.3%). Overall VE during the first 6 months after second dose was lower among PLWH with IDU history (65.8%, 95% CI = 43.5–79.3) than PLWH with no IDU history (80.3%, 95% CI = 62.7–89.6), and VE was particularly low at 4–6 months (42.4%, 95% CI = −17.8 to 71.8 with IDU history vs. 64.0%; 95% CI = 15.7–84.7 without), although confidence intervals were wide. In contrast, overall VE was 88.6% (95% CI = 88.2–89.0) in the matched HIV‐negative population with no history of IDU and remained relatively high at 4–6 months after second dose (84.6%, 95% CI = 83.8–85.4). Despite different patterns of vaccine protection by HIV status and IDU history, peak estimates were similar (≥88%) across all populations. Conclusions PLWH with a history of IDU may experience lower VE against COVID‐19 infection, although findings were limited by a small sample size. The lower VE at 4–6 months may have implications for booster dose prioritization for PLWH and people who inject drugs. The immunocompromising effect of HIV, substance use and/or co‐occurring comorbidities may partly explain these findings.https://doi.org/10.1002/jia2.26178COVID‐19SARS‐CoV‐2vaccine effectivenesspeople who use injection drugsHIV infectionCanada |
| spellingShingle | Joseph H. Puyat James Wilton Adeleke Fowokan Naveed Zafar Janjua Jason Wong Troy Grennan Catharine Chambers Abigail Kroch Cecilia T. Costiniuk Curtis L. Cooper Darren Lauscher Monte Strong Ann N. Burchell Aslam Anis Hasina Samji COVAXHIV Study Team COVID‐19 vaccine effectiveness by HIV status and history of injection drug use: a test‐negative analysis Journal of the International AIDS Society COVID‐19 SARS‐CoV‐2 vaccine effectiveness people who use injection drugs HIV infection Canada |
| title | COVID‐19 vaccine effectiveness by HIV status and history of injection drug use: a test‐negative analysis |
| title_full | COVID‐19 vaccine effectiveness by HIV status and history of injection drug use: a test‐negative analysis |
| title_fullStr | COVID‐19 vaccine effectiveness by HIV status and history of injection drug use: a test‐negative analysis |
| title_full_unstemmed | COVID‐19 vaccine effectiveness by HIV status and history of injection drug use: a test‐negative analysis |
| title_short | COVID‐19 vaccine effectiveness by HIV status and history of injection drug use: a test‐negative analysis |
| title_sort | covid 19 vaccine effectiveness by hiv status and history of injection drug use a test negative analysis |
| topic | COVID‐19 SARS‐CoV‐2 vaccine effectiveness people who use injection drugs HIV infection Canada |
| url | https://doi.org/10.1002/jia2.26178 |
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