Brief Report: Virologic and Immunologic Outcomes for HIV Patients With Coronavirus Disease 2019

Hu, Rong; Yan, Han; Liu, Manqing; Tang, Li; Kong, Wenhua; Zhu, Zerong; Liu, Pan; Bai, Wenjuan; Hu, Xuejiao; Ding, Jie; Wang, Xia; Xie, Nianhua

To describe the virologic and immunologic outcomes among people living with HIV (PLHIV) coinfected with SARS-CoV-2. SETTING: Wuhan, China. METHODS: Thirty-five coinfected patients were identified by matching the reported cases in National Notifiable Infectious Disease Report system for COVID-19 and HIV in Wuhan by time of April 19, 2020. Questionnaire-based survey and follow-up with blood sample collection were used to obtain characteristics before COVID-19 and after recovery. Nonparametric Mann–Whitney U test, χ(2), or Fisher exact test, Mcnemar test, and Wilcoxon test were conducted. RESULTS: Twenty of the 35 coinfected patients were identified as asymptomatic/mild/moderate COVID-19 (nonsevere group) and 15 were identified as severe/critical (severe group). The severe and nonsevere group had no differences in demographics, HIV baseline status, the intervals between last tests and follow-up tests for CD4(+) cell count and HIV-1 viral load (all P > 0.05). Overall, there was a significantly increased number of coinfected patients with HIV-1 viral load ≥20 copies/mL after recovery (P = 0.008). The median viral load increased significantly after recovery in severe group (P = 0.034), whereas no significant change of HIV-1 viral load was observed in the nonsevere group. Limited change of CD4(+) cell count was found (all P > 0.05). CONCLUSION: The coinfection of SARS-CoV-2 may put PLHIV at greater risk for HIV-1 viral rebound especially for severe/critical COVID-19, whereas it had limited impacts on CD4(+) cell count. Whether continuous antiretroviral therapy against HIV infection would have significant impacts on CD4(+) cell count among PLHIV coinfected with SARS-CoV-2 needs further research.