COVID-19 HIV 感染者中的突破性感染：全州队列分析。

IF 2.9 3区医学 Q3 IMMUNOLOGY

JAIDS Journal of Acquired Immune Deficiency Syndromes Pub Date : 2024-10-01 DOI:10.1097/qai.0000000000003475

Xueying Yang,Jiajia Zhang,Shujie Chen,Ziang Liu,Gregory A Poland,Bankole Olatosi,Sharon Weissman,Xiaoming Li

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引用次数: 0

摘要

设计与方法这项基于人群的回顾性队列研究使用了南卡罗来纳州（South Carolina，SC）综合电子健康记录（EHR）数据库中的数据。突破性感染的定义是：在 2022 年 6 月 14 日之前，个人完全接种疫苗（即接种 2 剂辉瑞/BNT162b2 或 Moderna/mRNA-1273 或 1 剂杨森/Ad26.COV2.S）后，国家机构记录的首次 COVID-19 诊断。结果在 7596 名完全接种疫苗的 PWH 中，突破性感染的总发生率为 118.95 例/1000 人-年。与α主导期相比，δ主导期（HR：1.50；95% CI：1.25 至 1.81）和Ω主导期（HR：2.86；95% CI：1.73 至 4.73）的突破性感染率较高。接受过加强剂量的个体发生突破性感染的可能性较低（HR：0.19；95% CI：0.15 至 0.24）。突破性感染与 HIV 病毒抑制程度无关，但 CD4 细胞计数越高，PWH 感染突破性感染的几率就越低（大于 500 cells/mm3 与小于 200 cells/mm3：HR：0.68；95% CI：0.49 至 0.94）。结论在我们的 PWH 群体中，突破性感染的发生率很高（在δ主导期和Ω主导期），主要与 50 岁以上、有合并症和 CD4 细胞数低的患者未接受加强剂量治疗有关。

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COVID-19 Breakthrough Infections Among People With HIV: A Statewide Cohort Analysis.

OBJECTIVES This study aims to identify COVID-19 breakthrough infections among people with HIV (PWH) across different phases of the pandemic and explore whether differential immune dysfunctions are associated with breakthrough infections. DESIGN AND METHODS This retrospective population-based cohort study used data from an integrated electronic health record (EHR) database in South Carolina (SC). Breakthrough infection was defined as the first COVID-19 diagnosis documented in the state agency after the date an individual was fully vaccinated (ie, 2 doses of Pfizer/BNT162b2 or Moderna/mRNA-1273, or 1 dose of Janssen/Ad26.COV2.S) through June 14, 2022. We analyzed the risk and associated factors of the outcome using Cox proportional hazards models. RESULTS Among 7596 fully vaccinated PWH, the overall rate of breakthrough infections was 118.95 cases per 1000 person-years. When compared with the alpha-dominant period, the breakthrough infection rate was higher during both delta-dominant (HR: 1.50; 95% CI: 1.25 to 1.81) and omicron-dominant (HR: 2.86; 95% CI: 1.73 to 4.73) periods. Individuals who received a booster dose had a lower likelihood of breakthrough infections (HR: 0.19; 95% CI: 0.15 to 0.24). There was no association of breakthrough infections with degree of HIV viral suppression, but a higher CD4 count was significantly associated with fewer breakthroughs among PWH (>500 vs <200 cells/mm3: HR: 0.68; 95% CI: 0.49 to 0.94). CONCLUSIONS In our PWH population, the incidence of breakthrough infections was high (during both delta-dominant and omicron-dominant periods) and mainly associated with the absence of a booster dose in patients older than 50 years, with comorbidities and low CD4 count.

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来源期刊

JAIDS Journal of Acquired Immune Deficiency Syndromes 医学-传染病学

CiteScore

5.80

自引率

5.60%

发文量

490

审稿时长

3-6 weeks

期刊介绍： JAIDS: Journal of Acquired Immune Deficiency Syndromes seeks to end the HIV epidemic by presenting important new science across all disciplines that advance our understanding of the biology, treatment and prevention of HIV infection worldwide. JAIDS: Journal of Acquired Immune Deficiency Syndromes is the trusted, interdisciplinary resource for HIV- and AIDS-related information with a strong focus on basic and translational science, clinical science, and epidemiology and prevention. Co-edited by the foremost leaders in clinical virology, molecular biology, and epidemiology, JAIDS publishes vital information on the advances in diagnosis and treatment of HIV infections, as well as the latest research in the development of therapeutics and vaccine approaches. This ground-breaking journal brings together rigorously peer-reviewed articles, reviews of current research, results of clinical trials, and epidemiologic reports from around the world.