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Rigshospitalet - a part of Copenhagen University Hospital
E-pub ahead of print

Outcomes following SARS-CoV-2 infection among individuals living with and without HIV; a Danish nationwide cohort study

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  • Line D Rasmussen
  • Susan Cowan
  • Jan Gerstoft
  • Gitte Kronborg
  • Isik S Johansen
  • Carsten S Larsen
  • Lothar Weise
  • Michael Dalager-Pedersen
  • Steffen Leth
  • Lars N Nielsen
  • Suzanne Lunding
  • Lars H Omland
  • Niels Obel
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OBJECTIVE: To compare the risk of a positive SARS-CoV-2 test and COVID-19 outcomes in people living with HIV (PLWH) with the general population, and estimate the association with vaccination status.

DESIGN: A nationwide, population based, matched cohort study.

METHODS: We included all Danish PLWH ≥18 years (n = 5,276) 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%CI: 0.8-0.9)], but a higher risk of first hospital contact with COVID-19 and hospitalization with severe COVID-19 for PLWH vs. controls [IRR: 2.0; (1.6-2.5), 1.8 (1.4-2.3)]. Risk of first hospitalization decreased substantially in PLWH 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 2-fold 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 PLWH who had received two vaccines PLWH 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: PLWH 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.

Original languageEnglish
JournalAIDS
ISSN0269-9370
DOIs
Publication statusE-pub ahead of print - 20 Sep 2022

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