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Distinct Immune Response to SARS-CoV-2 Among People Living with HIV

15 Pages Posted: 15 Dec 2020

See all articles by Mengmeng Wu

Mengmeng Wu

Wuhan University

Fangzhao Ming

Wuchang District Center for Disease Control and Prevention

Songjie Wu

Wuhan University

Yanbin Liu

Department of Infectious Diseases, Zhongnan Hospital of Wuhan University

Xiaoxia Zhang

Wuhan University - Department of Infectious Disease

Wei Guo

Wuhan University - Department of Pathology

Gifty Marly

Nanjing University - School of Public Health

Weiming Tang

University of North Carolina Project-China; Dermatology Hospital of Southern Medical University

Ke Liang

Wuhan University - Department of Infectious Disease; Wuhan University - Department of Nosocomial Infection; Chinese Academy of Medical Sciences - Wuhan Research Center for Infectious Diseases and Cancer; Wuhan University - Center of Preventing Mother-to-child Transmission for Infectious Diseases

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Abstract

Background: Although people living with HIV (PLWH) are immunodeficient, it is not clear if they are more susceptible to the SARS-CoV-2 infection than HIV-naïve individuals.

Methods: In this cross-sectional study, we recruited 857 PLWH (age≥18 years) who were in care in the Wuchang district and 1048 randomly selected HIV-naïve residents from the same district. We compared the rates of SARS-CoV-2 infection, the proportion of asymptomatic carriers, and the seroprevalence of antibodies in the two groups. The risk factors associated with SARS-CoV-2 infection among PLWH were explored.

Results: Fourteen out of 857 (1.63%) PLWH were infected with SARS-CoV-2, while 70 of 1048 (6.68%) HIV-naïve individuals were infected (P=0.001). The morbidity of COVID-19 was similar between the two groups, which were 0.70% and 0.38%, respectively (P=0.360). PLWH had more asymptomatic carriers (0.47%) than the HIV-naïve group (0.00%) (P=0.041). The proportion of unapparent patients in PLWH is lower in the HIV-naïve group (0.47% vs 6.30%, P=0.001). HIV and SARS-CoV-2 co-infected individuals were elder than HIV alone infected individuals (51.29±14.6 years vs 39.57±14.1years, P=0.020), and a higher proportion of chronic comorbidities was also observed among the co-infected group (5.81% vs 21.43%, P=0.048). Besides, PLWH with opportunistic infections (OIs) were easier to be infected with SARS-CoV-2 than those without OIs (P=0.005). Older age (aOR=4.50, 95%CI:1.34-15.13, P=0.015) and OIs (aOR=9.59, 95%CI:1.54-59.92, P=0.016) were risk factors for SARS-CoV-2 infection among PLWH by multivariable regression analysis.

Conclusion: PLWH have different infection forms and risk factors of SARS-CoV-2 than the general population, while opportunistic infections were considered to be a driving cause of SARS-CoV-2 infection among HIV infected individuals.

Funding Statement: 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), Medical Science and Technology Innovation Platform Support Project of Zhongnan Hospital, Wuhan University (PTXM2020008), Science and Technology Innovation Cultivation Fund of Zhongnan Hospital, Wuhan University (cxpy2017043). Medical Science Advancement Program (Basic Medical Sciences) of Wuhan University (TFJC2018004).

Declaration of Interests: The authors declare no conflict of interest.

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

Keywords: SARS-CoV-2, People living with human immunodeficiency virus (PLWH), asymptomatic carrier, unapparent infector

Suggested Citation

Wu, Mengmeng and Ming, Fangzhao and Wu, Songjie and Liu, Yanbin and Zhang, Xiaoxia and Guo, Wei and Marly, Gifty and Tang, Weiming and Liang, Ke, Distinct Immune Response to SARS-CoV-2 Among People Living with HIV. Available at SSRN: https://ssrn.com/abstract=3733604 or http://dx.doi.org/10.2139/ssrn.3733604

Mengmeng Wu

Wuhan University ( email )

Wuhan
China

Fangzhao Ming

Wuchang District Center for Disease Control and Prevention

China

Songjie Wu

Wuhan University ( email )

Wuhan
China

Yanbin Liu

Department of Infectious Diseases, Zhongnan Hospital of Wuhan University

Xiaoxia Zhang

Wuhan University - Department of Infectious Disease

China

Wei Guo

Wuhan University - Department of Pathology

Hubei, 430071
China

Gifty Marly

Nanjing University - School of Public Health ( email )

Nanjing, 211166
China

Weiming Tang

University of North Carolina Project-China ( email )

Guangzhou, 510095
China

Dermatology Hospital of Southern Medical University

Guangzhou
China

Ke Liang (Contact Author)

Wuhan University - Department of Infectious Disease ( email )

Wuhan, Hubei
China

Wuhan University - Department of Nosocomial Infection

Wuhan
China

Chinese Academy of Medical Sciences - Wuhan Research Center for Infectious Diseases and Cancer

Wuhan
China

Wuhan University - Center of Preventing Mother-to-child Transmission for Infectious Diseases

Wuhan
China

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