Factors associated with SARS-CoV-2 infection among people living with HIV: Data from the Balearic cohort (EVHIA)

by Francisca Artigues Serra, Sophia Pinecki Socias, Francisco Javier Fanjul, Maria Peñaranda, Francisco Homar, Patricia Sorni, Julia Serra, Adelaida Rey, Lola Ventayol, Maria Dolores Macia, Maria Àngels Ribas, Melchor Riera

Introduction

The impact of SARS-CoV-2 infection among people living with HIV (PLWH) has been a matter of research. We evaluated the incidence and factors associated with SARS-CoV-2 diagnosis among PLWH. We also assessed factors related to vaccination coverage in the Balearic Islands.

Methods

A retrospective analytical study was performed, including patients from the Balearic cohort (EVHIA) who were visited at least twice between 1^st January 2020 and 31^st March 2022. Chi-square test and Mann-Whitney U test were used to compare categorical and continuous variables respectively. Multivariable Cox proportional hazards regression models were estimated to identify risk factors.

Results

A total of 3567 patients with HIV were included. The median age was 51 years (IQR 44–59). Most of them were male (77,3%), from Europe (82,1%) or South America (13,8%). During the study period 1036 patients were diagnosed with SARS-CoV-2 infection (29%). The incidence rate was 153,24 cases per 1000 person-year. After multivariable analysis, men who have sex with men (MSM) were associated with an increased risk of SARS-CoV-2 infection (adjusted hazard ratio 1,324, 95% CI 1,138–1,540), whereas African origin, tobacco use and complete or booster vaccination coverage were negatively related. Overall, complete vaccination or booster coverage was recorded in 2845 (79,75%) patients. When analysing vaccination uptake, older patients (adjusted hazard ratio 5,122, 95% CI 3,170–8,288) and those with a modified comorbidity index of 2–3 points (adjusted hazard ratio 1,492, 95% CI 1,056–2,107) had received more vaccine doses.

Conclusions

In our study no HIV related factor was associated with an increased risk of SARS-CoV-2 infection, except for differences in the transmission route. Possible confounding variables such as mask wearing or social interactions could not be measured. Vaccines were of utmost importance to prevent SARS-CoV-2 infection. Efforts should be made to encourage vaccination in those groups of PLWH with less coverage.