TY - JOUR

T1 - Outcomes following severe acute respiratory syndrome coronavirus 2 infection among individuals with and without HIV in Denmark

AU - Rasmussen, Line D.

AU - Cowan, Susan

AU - Gerstoft, Jan

AU - Kronborg, Gitte

AU - Johansen, Isik S.

AU - Larsen, Carsten S.

AU - Weise, Lothar

AU - Dalager-Pedersen, Michael

AU - Leth, Steffen

AU - Nielsen, Lars N.

AU - Lunding, Suzanne

AU - Omland, Lars H.

AU - Obel, Niels

N1 - Funding Information: We thank the staff in test sites and in the hospital Departments of Clinical Microbiology. We further wish to thank staff at the Department of Virus & Microbiological Special Diagnostics, Test Center Denmark, and the staff of the Data Integration and Analysis Secretariat (DIAS), all at Statens Serum Institut. Publisher Copyright: © 2022 Wolters Kluwer Health, Inc. All rights reserved.

PY - 2023

Y1 - 2023

N2 - Objective: To compare the risk of a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test and coronavirus disease 2019 (COVID-19) outcomes in people with HIV (PWH) with the general population, and estimate the association with vaccination status. Design: A nationwide, population based, matched cohort studyMethods: We included all Danish PWH ≥18years (n=5276) and an age and sex-matched general population cohort (n=42 308). We used Cox regression analyses to calculate (adjusted) incidence rate ratios [(a)IRR] and further stratified and restricted the analyses. Results: We observed no major difference in risk of first positive SARS-CoV-2 test [aIRR: 0.8 (95% confidence interval (CI): 0.8-0.9)], but a higher risk of first hospital contact with COVID-19 and hospitalization with severe COVID-19 for PWH vs. controls [IRR: 2.0; (1.6-2.5), 1.8 (1.4-2.3)]. Risk of first hospitalization decreased substantially in PWH with calendar time [first half of year 2022 vs. 2020 IRR: 0.3; (0.2-0.6)], whereas the risk compared to population controls remained almost twofold increased. We did not observe increased risk of death after SARS-CoV-2 infection [aIRR: 0.7 (95% CI: 0.3-2.0)]. Compared to PWH who had received two vaccines PWH who receiving a third vaccine had reduced risk of first positive SARS-CoV-2 test, death (individuals ≥60years) and hospitalization [aIRR: 0.9 (0.7-1.0); 0.2 (0.1-0.7); 0.6 (0.2-1.2)]. Conclusion: PWH have almost the same risk of a positive SARS-CoV-2 test as the general population. Although risk of hospital contacts and severe outcomes following SARS-CoV-2 infection is increased, the risk of death does not seem to be substantially increased. Importantly, a third vaccine is associated with reduced risk of infection, and death.

AB - Objective: To compare the risk of a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test and coronavirus disease 2019 (COVID-19) outcomes in people with HIV (PWH) with the general population, and estimate the association with vaccination status. Design: A nationwide, population based, matched cohort studyMethods: We included all Danish PWH ≥18years (n=5276) and an age and sex-matched general population cohort (n=42 308). We used Cox regression analyses to calculate (adjusted) incidence rate ratios [(a)IRR] and further stratified and restricted the analyses. Results: We observed no major difference in risk of first positive SARS-CoV-2 test [aIRR: 0.8 (95% confidence interval (CI): 0.8-0.9)], but a higher risk of first hospital contact with COVID-19 and hospitalization with severe COVID-19 for PWH vs. controls [IRR: 2.0; (1.6-2.5), 1.8 (1.4-2.3)]. Risk of first hospitalization decreased substantially in PWH with calendar time [first half of year 2022 vs. 2020 IRR: 0.3; (0.2-0.6)], whereas the risk compared to population controls remained almost twofold increased. We did not observe increased risk of death after SARS-CoV-2 infection [aIRR: 0.7 (95% CI: 0.3-2.0)]. Compared to PWH who had received two vaccines PWH who receiving a third vaccine had reduced risk of first positive SARS-CoV-2 test, death (individuals ≥60years) and hospitalization [aIRR: 0.9 (0.7-1.0); 0.2 (0.1-0.7); 0.6 (0.2-1.2)]. Conclusion: PWH have almost the same risk of a positive SARS-CoV-2 test as the general population. Although risk of hospital contacts and severe outcomes following SARS-CoV-2 infection is increased, the risk of death does not seem to be substantially increased. Importantly, a third vaccine is associated with reduced risk of infection, and death.

KW - coronavirus disease 2019

KW - HIV, CD4cell count

KW - severe acute respiratory syndrome coronavirus 2

KW - severe acute respiratory syndrome coronavirus 2 vaccines

UR - http://www.scopus.com/inward/record.url?scp=85144590168&partnerID=8YFLogxK

U2 - 10.1097/QAD.0000000000003393

DO - 10.1097/QAD.0000000000003393

M3 - Journal article

C2 - 36129108

AN - SCOPUS:85144590168

VL - 37

SP - 311

EP - 321

JO - AIDS

JF - AIDS

SN - 1350-2840

IS - 2

ER -