Driving force of COVID-19 among people living with HIV in Wuhan, China

ABSTRACT

Background

Although people living with HIV (PLWH) were considered to be at increased risk of SARS-CoV-2 infection, the driving force among this group of individuals is still not clear.

Methods

We investigated 1,709 PLWH through a telephone interview and identified 11 COVID-19 patients in four districts of Wuhan, China. The demographic features and major clinical characteristics of these patients were retrieved from the information management systems for COVID-19 patients of the four districts’ CDC. Statistical analysis was performed to find out the driving force of COVID-19 among PLWH.

Results

The prevalence of COVID-19 in PLWH is 0.6% (95% CI: 0.2% - 1.0%), which is comparable to the overall population prevalence in Wuhan city (0.6%). Nine out of the 11 COVID-19 patients had relatively high CD4+ T lymphocyte count (>200/μl) and undetectable HIV viral load (<20 copies/ml), and ten of them were on antiretroviral therapy. Older PLWH with low CD4 + count, got HIV infected through homosexual activity, and had been diagnosed with HIV for a long time, were more likely to develop COVID-19.

Conclusions

COVID-19 related morbidity rates were comparable between PLWH and the general population. Older age with low CD4 count, an extended period of HIV diagnosis, and treatment-naivety were potential driving forces of COVID-19 prevalence among PLWH. Strategies for preventing SARS-CoV-2 infection among PLWH with weak immune responses are required.

KEYWORDS:

• COVID-19
• People living with HIV (PLWH)
• morbidity
• risk factor

Acknowledgment

The authors thank all the participants for their contribution and thank all health-care workers who involved in COVID-19 diagnosis and treatment of patients, and thank Gifty Marley for the proofreading of the manuscript.

Authors’ contribution

WT, YF, and KL have full access to all of the data. WG, YF, WT, and KL conceived the research. FM, QZ, LL, PM, XZ, MG collected all the data. DY, WG, WT, and KL analyzed the data and drafted the manuscript.

Availability of data and material

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics approval

This study was approved by the Ethics Committee of Zhongnan Hospital affiliated with Wuhan University (2020062), and informed consent was obtained.

Additional information

Funding

This work was supported by the National Key Research and Development Program of China (2017YFE0103800), the National Nature Science Foundation of China (81903371), NIMH (R34MH119963), the National Science and Technology Major Project (2018ZX10101-001-001-003), and Special Found on Prevention and Control of New Coronary Pneumonia in Guangdong Universities (2020KZDZX1047) to WT. Medical Science and Technology Innovation Platform Support Project of Zhongnan Hospital, Wuhan University (PTXM2020008), The Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences (2020-PT320-004), Science and Technology Innovation Cultivation Fund of Zhongnan Hospital, Wuhan University (cxpy2017043). Medical Science Advancement Program (Basic Medical Sciences) of Wuhan University (TFJC2018004) to KL.