感染了 Omicron 变体的艾滋病病毒感染者的 COVID-19 症状较轻:一项横断面研究的结果。

IF 2.1 4区 医学 Q3 INFECTIOUS DISEASES
Yuting Tan, Songjie Wu, Fangzhao Ming, Jie Liu, Gifty Marley, Aiping Yu, Yanhe Luo, Shi Zou, Wei Guo, Weiming Tang, Ke Liang
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引用次数: 0

摘要

背景:在调整 "零COVID "战略后,中国正准备迎接2019年冠状病毒病(COVID-19)的激增。我们旨在评估和比较艾滋病病毒感染者(PLWH)和无艾滋病病毒感染者中感染奥米克龙变异株临床症状的流行情况:方法:我们于 2022 年 12 月在湖北省武汉市武昌区开展了一项横断面研究,在 "奥米克龙 "流行期间进行了一次自填式在线调查。调查对象年龄≥18 岁,确诊为严重急性呼吸系统综合征冠状病毒 2 型(SARS-CoV-2)。我们还招募了由当地医疗系统管理的 PLWH,并通过微信发送在线调查问卷的方式招募了未感染 HIV 的人群。我们比较了感染者和非感染者中 COVID-19 临床症状的发生率,并了解了感染者中出现症状的相关因素:共有 687 名 PLWH 和 1222 名无 HIV 感染者参与了调查。在对性别、年龄、体重指数、合并症和 COVID-19 疫苗接种情况进行调整后,PLWH 中所有症状的发生率,包括发热程度较高和持续时间较长(aOR 0.51,95%CI 0-42 - 0-61;aOR 0.52,95%CI 0-43 - 0-63),均显著低于无 HIV 感染者。在 PLWH 中,CD4+ T 淋巴细胞计数(CD4 细胞数)在 350 ~ 499 cells/µL 之间和可检测到的 HIV 病毒载量(HIV-VL)与发热风险的显著降低有关(aOR 0-63,95%CI 0-40 - 0-97;aOR 0-56,95%CI 0-40 - 0-97;aOR 0-56,95%CI 0-40 - 0-97);aOR 0-56,95%CI 0-33 - 0-94)、头痛(aOR 0-61,95%CI 0-41 - 0-91;aOR 0-55,95%CI 0-34 - 0-92)和肌肉酸痛(aOR 0-57,95%CI 0-39 - 0-84;aOR 0-57,95%CI 0-39 - 0-84)。在 PLWH 中,未观察到症状发生率与接种三/四剂 COVID-19 灭活疫苗之间有明显关联;男性和年龄较大与鼻塞/流鼻涕风险显著降低有关(aOR 0-52,95%CI 0-32 - 0-82;aOR 0-97,95%CI 0-39 - 0-84);aOR 0-97,95%CI 0-96 - 0-99)和头痛(aOR 0-58,95%CI 0-36 - 0-92;aOR 0-96,95%CI 0-95 - 0-98);年龄越大,发热程度越高的风险显著降低(aOR 0-97,95%CI 0-95 - 0-98)。结论与未感染艾滋病毒的人相比,艾滋病毒感染者的奥米克龙变异感染症状明显较轻。男性、年龄较大、CD4 细胞计数较低、检测到 HIV-VL 的 PLWH 的 COVID-19 症状发生率较低。不过,在 COVID-19 大流行期间,应对 PLWH 进行持续监测。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
People living with HIV with the Omicron variant infection have milder COVID-19 symptoms: results from a cross-sectional study.

Background: China braces for coronavirus disease 2019 (COVID-19) surge after adjusting the "zero COVID" strategy. We aimed to evaluate and compare the prevalence of clinical symptoms of the Omicron variant infection among people living with HIV (PLWH) and HIV-free people.

Methods: A cross-sectional study was conducted in Wuchang District, Wuhan, Hubei Province, in December 2022 by a self-administered online survey during the Omicron wave. Participants aged ≥ 18 years with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnosis were recruited. PLWH managed by the local healthcare system were recruited, while HIV-free people were recruited by sending out online surveys through WeChat. We compared the prevalence of clinical symptoms of COVID-19 between PLWH and HIV-free people, and factors associated with symptom occurrence among PLWH were accessed.

Results: Total, 687 PLWH and 1222 HIV-free people were enrolled. After adjusting sex, age, body mass index, comorbidities and COVID-19 vaccination status, the prevalences of all symptoms, including higher degree and long duration of fever (aOR 0.51, 95%CI 0·42 - 0·61; aOR 0.52, 95%CI 0·43 - 0·63), were significantly lower among PLWH than among HIV-free people. Among PLWH, CD4+ T lymphocyte count (CD4 count) between 350 ~ 499 cells/µL and detectable HIV viral load (HIV-VL) were associated with significantly decreased risks of fever (aOR 0·63, 95%CI 0·40 - 0·97; aOR 0·56, 95%CI 0·33 - 0·94), headache (aOR 0·61, 95%CI 0·41 - 0·91; aOR 0·55, 95%CI 0·34 - 0·92) and muscle soreness (aOR 0·57, 95%CI 0·39 - 0·84; aOR 0·57, 95%CI 0·39 - 0·84). No apparent association between the symptoms prevalence and three/four doses of inactivated COVID-19 vaccination among PLWH was observed; both males and older age were associated with significantly decreased risks of nasal congestion/runny nose (aOR 0·52, 95%CI 0·32 - 0·82; aOR 0·97, 95%CI 0·96 - 0·99) and headache (aOR 0·58, 95%CI 0·36 - 0·92; aOR 0·96, 95%CI 0·95 - 0·98); older age was associated with significantly decreased risks of higher degree of fever (aOR 0·97, 95%CI 0·95 - 0·98).

Conclusions: PLWH have significantly milder symptoms of the Omicron variant infection than HIV-free people. PLWH who are male, older, have low CD4 count, and detectable HIV-VL have reduced occurrence of COVID-19 symptoms. However, continuous monitoring should be conducted among PLWH during the COVID-19 pandemic.

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来源期刊
AIDS Research and Therapy
AIDS Research and Therapy INFECTIOUS DISEASES-
CiteScore
3.80
自引率
4.50%
发文量
51
审稿时长
16 weeks
期刊介绍: AIDS Research and Therapy publishes articles on basic science, translational, clinical, social, epidemiological, behavioral and educational sciences articles focused on the treatment and prevention of HIV/AIDS, and the search for the cure. The Journal publishes articles on novel and developing treatment strategies for AIDS as well as on the outcomes of established treatment strategies. Original research articles on animal models that form an essential part of the AIDS treatment research are also considered
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