Real-world effectiveness of COVID-19 vaccine in people with HIV compared with a matched HIV-negative cohort: A test-negative design.

IF 4.8 2区 医学 Q1 INFECTIOUS DISEASES
Xueying Yang, Jiajia Zhang, Ziang Liu, Shujie Chen, Sharon Weissman, Gregory A Poland, Refilwe Nancy Phaswana-Mafuya, Bankole Olatosi, Xiaoming Li
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Abstract

Objectives: We estimated vaccine effectiveness (VE) against SARS-CoV-2 infection among a statewide cohort of people with HIV (PWH) and compared the estimates with a matched cohort of people without HIV (PWoH) in South Carolina (SC), USA.

Methods: A population-based cohort was retrieved from statewide electronic health records between January 2, 2021, and April 14, 2022, during which several variants were circulating in SC (i.e., Alpha, Delta, Omicron). We compared the odds of vaccination between test-positive cases and test-negative controls using logistic regression models for both SARS-CoV-2 infection and severe COVID-19 outcomes. The VE was derived as (1 - adjusted odds ratio) × 100%.

Results: A total of 7279 test episodes in PWH and 72,790 matched test episodes in PWoH were included for analysis, representing 6561 unique PWH and 67,521 unique PWoH. The peak level of VE against SARS-CoV-2 infection occurred 7-59 days after receipt of the second dose of vaccine (PWH: 61.20%; PWoH: 67.09%), followed by a waning protective effect 90-119 days after the second dose in both PWH (35.80%) and PWoH (47.57%), where PWH had a proportionally lower and declined faster VE. Regarding the VE against severe outcomes of SARS-CoV-2 infection, a relatively higher level of protection was maintained in both populations (complete primary series: PWH: 69.06%; PWoH: 60.63%).

Conclusions: A complete primary series of COVID-19 vaccines offered significant protection against SARS-CoV-2 infection and severe outcomes in both PWH and PWoH populations, although this wanes with time. However, the estimate of VE against SARS-CoV-2 infection appeared lower in PWH than in PWoH and the degree of waning over time was relatively quicker in PWH.

COVID-19 疫苗在艾滋病病毒感染者中的实际效果与匹配的艾滋病病毒阴性队列的比较:试验阴性设计。
背景:我们估算了全州艾滋病病毒感染者(PWH)感染 SARS-CoV-2 疫苗的有效性(VE),并将估算结果与美国南卡罗来纳州(SC)无艾滋病病毒感染者(PWoH)的匹配队列进行了比较:从全州电子健康记录中检索了 2021 年 1 月 2 日至 2022 年 4 月 14 日期间的人群队列,在此期间,南卡罗来纳州流行着几种变异株(即 Alpha、Delta 和 Omicron)。我们使用逻辑回归模型比较了检测呈阳性的病例和检测呈阴性的对照组之间接种疫苗的几率,并对 SARS-CoV-2 感染和严重 COVID-19 结果进行了比较。VE值为(1-调整后的几率)×100%:共有 7,279 例威利什病患者和 72,790 例匹配的威利什病患者被纳入分析,其中威利什病患者 6,561 例,威利什病患者 67,521 例。接种第二剂疫苗后 7-59 天,预防 SARS-CoV-2 感染的 VE 达到最高水平(PWH:61.20%;PWoH:67.09%),随后,在接种第二剂疫苗 90-119 天后,PWH(35.80%)和 PWoH(47.57%)的保护效果逐渐减弱,其中,PWH 的 VE 比例较低,且下降速度较快。关于对 SARS-CoV-2 感染严重后果的 VE,两种人群都保持了相对较高的保护水平(完整的初级系列:PWH:69.06%;PWoH:60.63%):结论:COVID-19 疫苗的完整初级接种系列在预防 SARS-CoV-2 感染和严重后果方面对 PWH 和 PWoH 群体都有显著的保护作用,尽管这种保护作用会随着时间的推移而减弱。不过,威利斯人和残疾人对 SARS-CoV-2 感染的 VE 估计值似乎低于威利斯人和残疾人,而且威利斯人和残疾人的 VE 随时间减弱的程度相对较快。
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来源期刊
CiteScore
18.90
自引率
2.40%
发文量
1020
审稿时长
30 days
期刊介绍: International Journal of Infectious Diseases (IJID) Publisher: International Society for Infectious Diseases Publication Frequency: Monthly Type: Peer-reviewed, Open Access Scope: Publishes original clinical and laboratory-based research. Reports clinical trials, reviews, and some case reports. Focuses on epidemiology, clinical diagnosis, treatment, and control of infectious diseases. Emphasizes diseases common in under-resourced countries.
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