Given the experience of many long-term survivors living through the first 2 decades of the AIDS epidemic, the isolation, scientific uncertainty, and lack of actionable medical interventions have revived many parallel concerns for PWH.[17,54,55] Developing clear understanding of whom among those with HIV is at an increased risk for severe outcomes with this new pathogen, and which risks are modifiable, can mitigate both the medical and psychological burden to PWH during this pandemic. Results of this large multisite cohort study demonstrate that older PWH with a CD4 cell count <350 cells/mm3 or historic CD4 counts <200 cells/mm3 have a higher risk of severe COVID-19 disease. Comorbidities including CKD, liver fibrosis, COPD, diabetes, hypertension, obesity, and cardiovascular risk also impart an increased risk of severe COVID-19 in PWH. PWH with these risk factors should be strongly encouraged to receive preventive vaccines and boosters and should be prioritized for allocation of early therapeutics such as monoclonal antibodies.
Funding for this study and for CNICS came from the US National Institutes of Health: National Institute of Allergy and Infectious Diseases (NIAID) [CNICS R24 AI067039; UW CFAR NIAID Grant P30 AI027757; UAB CFAR Grant P30 AI027767; UNC CFAR Grant P30 AI50410; UCSD CFAR Grant P30 AI036214; Case Western Reserve University CFAR Grant P30 AI036219; Fenway Health/Harvard CFAR Grant P30 AI060354; UCSF CFAR Grant P30 AI027763; and JHU CFAR Grant P30 AI094189] and the National Institute on Drug Abuse (NIDA) [R01DA047045]. The funders had no role in the design, conduct, or reporting of the study.
The authors thank the CNICS cohort participants and their providers for contributing to the study.
J Acquir Immune Defic Syndr. 2022;90(4):369-376. © 2022 Lippincott Williams & Wilkins