Virologic and Immunologic Outcomes for HIV Patients With Coronavirus Disease 2019

Rong Hu, MPH; Han Yan, MPH; Manqing Liu, MSc; Li Tang, MPH; Wenhua Kong, MSc; Zerong Zhu, MSc; Pan Liu, MSc; Wenjuan Bai, MPH; Xuejiao Hu, MPH; Jie Ding, BD; Xia Wang, MPH; Nianhua Xie, MPH


J Acquir Immune Defic Syndr. 2021;86(2):213-218. 

In This Article


We retrospectively reviewed a total of 35 cases of PLHIV with SARS-CoV-2 infection in Wuhan by the time of April 19, 2020, identified by matching reported COVID-19 with registered PLHIV in the National Notifiable Infectious Disease Report System every half month since early March, 2020. According to the Diagnosis, Treatment and Prevention Scheme for COVID-19, COVID-19 was categorized into confirmed cases, clinically diagnosed cases, suspected cases, and asymptomatic cases, and the severity of COVID-19 was categorized into mild, moderate, severe, or critical.[6,7] In this study, we only included PLHIV with confirmed COVID-19, clinically diagnosed COVID-19, and asymptomatic COVID-19. Considering the small number of patients in different severity, the severe/critical COVID-19 were classified into severe group and asymptomatic/mild/moderate COVID-19 were classified into nonsevere group.

Demographical data and baseline HIV status were extracted from the National Notifiable Infectious Disease Report System. Considering the regular follow-up of at least once a year for HIV-1 viral load and CD4+ cell count among PLHIV, patients' last HIV-1 viral load and CD4+ cell count in 2019, namely the tests within previous 12 months in 2019, were extracted as the data before COVID-19. A tele-survey on COVID-19-related clinical and epidemiological information was conducted in local Centers for Disease Control and Prevention (CDCs) from March 10 to April 22, 2020. Subsequent follow-up by questionnaire survey and blood sample collection was conducted in local CDCs from May 18 to May 19, 2020. Follow-up questionnaire survey mainly included information regarding history of comorbidities, alcohol consumption, smoking, and antiretroviral therapy (ART) discontinuation in the epidemic period. Alcohol consumption was generally classified as ever and current, abstainer, and never according to a meta-analysis on alcohol consumption and risk of dementia.[8] Smoking was defined as ever and current, ex/former, and never, the most commonly used categories summarized in a meta-analysis on smoking and risk of pneumonia.[9] ART discontinuation was measured by asking a question of "whether you had a history of discontinuing ART for at least 3 days since December, 2019." Blood samples were tested for HIV-1 viral load, CD4+ cell count, biochemical data related to toxic side effects of ART against HIV infection, and antibody seroactivity against SARS-CoV-2 in the laboratory in Wuhan CDC. The lower limit of HIV-1 viral load detection was 20 copies/mL.

Continuous and categorical data were presented as medians with interquartile ranges (IQRs) and absolute numbers with percentages, respectively. The differences of demographics, baseline HIV status, and clinical findings related to COVID-19 among different groups were tested by nonparametric Mann–Whitney U test and χ 2 or Fisher exact test. The differences of HIV-1 viral load, CD4 cell count, and biochemical data related to toxic side effects of ART before COVID-19 and after recovery were tested by McNemar test and Wilcoxon test. P < 0.05 was considered as level of significance. Analyses were performed using SPSS version 22.0 and R version 3.5.2.

Ethical approval was obtained from the Institutional Review Board of Wuhan Center for Disease Control and Prevention (WHCDCIRB-K-2020016). Oral and written informed consents were obtained for subjects willing to participate in tele-survey and follow-up study, respectively.