COVID-19 and HIV/AIDS in a cohort study in Sao Paulo, Brazil: outcomes and disparities by race and schooling

Efficacy of COVID-19 Vaccination in People Living with HIV/AIDS in a Northern Brazil: Cross-Sectional Study

BACKGROUND/OBJECTIVES

The evaluation of the efficacy of COVID-19 vaccination in immunocompromised individuals, such as people living with HIV/AIDS (PLWH), still is of great global importance. The present study aimed to describe the presence of anti-SARS-CoV-2 IgG antibodies in PLWH vaccinated and unvaccinated against COVID-19 in the city of Belém, northern Brazil.

METHODS

A cross-sectional study involving 510 PLWH was conducted from December 2021 to May 2022. Participants answered a sociodemographic questionnaire and subsequently underwent an anti-SARS-CoV-2 enzyme immunoassay for the detection of IgG antibodies, as well as quantification of CD4+ T lymphocytes and HIV-1 plasma viral load.

RESULTS

Most participants were male (70%), aged 25-50 years (72%), single (71.4%), and low-income (50.4%). The prevalence of anti-SARS-CoV-2 IgG antibodies was 94.3% (481/510), with most vaccinated individuals having received at least two doses of a COVID-19 vaccine. An association was observed between antibody levels and the number of vaccine doses, CD4+ T lymphocyte count, CD4+/CD8+ T lymphocyte ratio, and HIV-1 viral load.

CONCLUSIONS

PLWH developed high levels of antibodies against SARS-CoV-2 after receiving the vaccine, demonstrating that COVID-19 vaccination is of fundamental importance for the protection against severe COVID-19 in this specific group of immunocompromised individuals.

The Impact of COVID-19 on HIV Care in Rio de Janeiro, Brazil 2019-2021: Disparities by Age and Gender

We evaluated COVID-19's impact on HIV care indicators among INI/FIOCRUZ's HIV Clinical Cohort in Rio de Janeiro, Brazil: (1) Adequate care visits: two visits ≥ 90 days apart; (2) Adequate viral load monitoring: ≥ 2 viral load results ≥ 90 days apart; (3) Consistent viral suppression: all viral loads < 40 copies/mL; and (4) ART medication possession ratio (MPR) ≥ 95%. Chi-square tests compared the fraction of participants meeting each indicator per period: pre-pandemic (3/1/2019-2/29/2020) and post-pandemic (3/1/2020-2/28/2021). Logistic regression models were used to assess disparities in adequate care visits. Among 906 participants, care visits and viral load monitoring decreased pre-pandemic to post-pandemic: 77.0-55.1% and 36.6-11.6% (both p < 0.001), respectively. The optimal MPR rate improved from 25.5 to 40.0% (p < 0.001). Post-pandemic period (aOR 0.33, CI 0.28-0.40), transgender women (aOR 0.34, CI 0.22-0.53), and those aged 18-24 years (aOR 0.67, CI 0.45-0.97) had lower odds of adequate care visits. COVID-19 disrupted care access disproportionately for transgender women and younger participants.

Risk Factors for COVID-19 Mortality Among People Living with HIV: A Scoping Review

People living with HIV (PLWH) are particularly vulnerable to worsened outcomes of COVID-19. Therefore, the purpose of this work was to provide a scoping review of the literature to assess the risk factors for COVID-19 mortality among PLWH. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR), searches were conducted in PubMed, Scopus, Global Health, and WHO Coronavirus Database. Articles were eligible for inclusion if they were in English, included PLWH who died after COVID-19 infection, and described risk factors for mortality. Results were descriptively synthesized and pooled thereafter. Study quality was assessed using the Joanna Brigg Institute's critical appraisal tools. 20 studies were eligible for inclusion, with the pooled death rate being 11.7%. Age was a major risk factor, especially after 50 (23.2%) and after 70 (41.8%), and males had a death rate nearly double that of females. As total comorbidities increased, the death rate also greatly increased; among those with comorbidities, the highest fatality rates were those with cardiovascular disease (30.2%), chronic kidney disease (23.5%), obesity (22.4%), and diabetes (18.4%). Other risk factors for mortality among PLWH included having a Black racial background, being an injection drug user, being a smoker, and having a CD4 cell count below 200. There is a need to better study confounding factors, and to understand how vaccination influences mortality risk. Overall, the findings highlight a need to ensure that focus is placed on the varying demographics of PLWH amidst COVID-19 control efforts.