Risk of adverse coronavirus disease 2019 outcomes for people living with HIV
<p><strong>Objective:</strong> To assess whether people living with HIV (PLWH) are at increased risk of COVID-19 mortality or adverse outcomes, and whether antiretroviral therapy (ART) influences this risk.</p> <p><strong>Design:</strong> Rapid review with...
| Main Authors: | , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Lippincott, Williams and Wilkins
2021
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| _version_ | 1826280625063067648 |
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| author | Mellor, MM Bast, AC Jones, NR Roberts, NW Ordonez-Mena, J Reith, AJM Butler, CC Matthews, PC Dorward, J |
| author_facet | Mellor, MM Bast, AC Jones, NR Roberts, NW Ordonez-Mena, J Reith, AJM Butler, CC Matthews, PC Dorward, J |
| author_sort | Mellor, MM |
| collection | OXFORD |
| description | <p><strong>Objective:</strong> To assess whether people living with HIV (PLWH) are at increased risk of COVID-19 mortality or adverse outcomes, and whether antiretroviral therapy (ART) influences this risk.</p>
<p><strong>Design:</strong> Rapid review with meta-analysis and narrative synthesis.</p>
<p><strong>Methods:</strong> We searched databases including Embase, Medline, medRxiv, and Google Scholar up to 26th August 2020 for studies describing COVID-19 outcomes in PLWH and conducted a meta-analysis of higher quality studies.
Results: We identified 1,908 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 (HR) 1.95, 95% Confidence Interval (CI): 1.62-2.34) compared to people without HIV. Risk of death remained elevated for PLWH in a subgroup analysis of hospitalised cohorts (HR 1.60, 95% CI: 1.12-2.27) and studies of PLWH across all settings (HR 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 (TDF)-based regimens were associated with a lower risk of adverse COVID-19 outcomes, although these analyses are susceptible to confounding by comorbidities.</p>
<p><strong>Conclusion:</strong> Emerging evidence suggests a moderately increased risk of COVID-19 mortality amongst PLWH. Further investigation into the relationship between COVID-19 outcomes and CD4+ T cell count, HIV viral load, ART and the use of TDF is warranted.</p> |
| first_indexed | 2024-03-07T00:16:29Z |
| format | Journal article |
| id | oxford-uuid:7b024443-7055-49e0-8b40-3b218b031ee1 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T00:16:29Z |
| publishDate | 2021 |
| publisher | Lippincott, Williams and Wilkins |
| record_format | dspace |
| spelling | oxford-uuid:7b024443-7055-49e0-8b40-3b218b031ee12022-03-26T20:47:54ZRisk of adverse coronavirus disease 2019 outcomes for people living with HIVJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:7b024443-7055-49e0-8b40-3b218b031ee1EnglishSymplectic ElementsLippincott, Williams and Wilkins2021Mellor, MMBast, ACJones, NRRoberts, NWOrdonez-Mena, JReith, AJMButler, CCMatthews, PCDorward, J<p><strong>Objective:</strong> To assess whether people living with HIV (PLWH) are at increased risk of COVID-19 mortality or adverse outcomes, and whether antiretroviral therapy (ART) influences this risk.</p> <p><strong>Design:</strong> Rapid review with meta-analysis and narrative synthesis.</p> <p><strong>Methods:</strong> We searched databases including Embase, Medline, medRxiv, and Google Scholar up to 26th August 2020 for studies describing COVID-19 outcomes in PLWH and conducted a meta-analysis of higher quality studies. Results: We identified 1,908 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 (HR) 1.95, 95% Confidence Interval (CI): 1.62-2.34) compared to people without HIV. Risk of death remained elevated for PLWH in a subgroup analysis of hospitalised cohorts (HR 1.60, 95% CI: 1.12-2.27) and studies of PLWH across all settings (HR 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 (TDF)-based regimens were associated with a lower risk of adverse COVID-19 outcomes, although these analyses are susceptible to confounding by comorbidities.</p> <p><strong>Conclusion:</strong> Emerging evidence suggests a moderately increased risk of COVID-19 mortality amongst PLWH. Further investigation into the relationship between COVID-19 outcomes and CD4+ T cell count, HIV viral load, ART and the use of TDF is warranted.</p> |
| spellingShingle | Mellor, MM Bast, AC Jones, NR Roberts, NW Ordonez-Mena, J Reith, AJM Butler, CC Matthews, PC Dorward, J Risk of adverse coronavirus disease 2019 outcomes for people living with HIV |
| title | Risk of adverse coronavirus disease 2019 outcomes for people living with HIV |
| title_full | Risk of adverse coronavirus disease 2019 outcomes for people living with HIV |
| title_fullStr | Risk of adverse coronavirus disease 2019 outcomes for people living with HIV |
| title_full_unstemmed | Risk of adverse coronavirus disease 2019 outcomes for people living with HIV |
| title_short | Risk of adverse coronavirus disease 2019 outcomes for people living with HIV |
| title_sort | risk of adverse coronavirus disease 2019 outcomes for people living with hiv |
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