Isabela Killander Möller, Pontus Hedberg, Philippe Wagner, Hannes Lindahl, Sofia Nyström, Lisa Blixt, Sandra Eketorp Sylvan, Åsa Nilsdotter-Augustinsson, Anders Österborg, Mats Fredrikson, Lotta Hansson, Fredrik Kahn, Pär Sparén, Magnus Gisslén, Pontus Nauclér, Peter Bergman, Soo Aleman, Christina Carlander
{"title":"瑞典一项以全国登记为基础的队列研究中，按艾滋病病毒感染状况和非典-CoV-2 疫苗接种状况分列的 COVID-19 住院风险（前奥美康时代和后奥美康时代）。","authors":"Isabela Killander Möller, Pontus Hedberg, Philippe Wagner, Hannes Lindahl, Sofia Nyström, Lisa Blixt, Sandra Eketorp Sylvan, Åsa Nilsdotter-Augustinsson, Anders Österborg, Mats Fredrikson, Lotta Hansson, Fredrik Kahn, Pär Sparén, Magnus Gisslén, Pontus Nauclér, Peter Bergman, Soo Aleman, Christina Carlander","doi":"10.1080/23744235.2024.2405582","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Data on the outcomes of COVID-19 in people living with HIV (PLHIV), specifically in relation to vaccination status, are lacking during the Omicron era.</p><p><strong>Methods: </strong>This nationwide registry-based study included all resident in Sweden ≥18 years with a positive SARS-CoV-2 PCR test during January 2021-February 2023. We estimated adjusted odds ratios (adjOR) for COVID-19 hospitalisation and severe COVID-19 (ICU admission and 90-day mortality), categorised by SARS-CoV-2 vaccination status (0-1, 2, and ≥3 doses), and HIV-status. Analyses were then categorised by time periods of pre-Omicron, Omicron during public testing, and Omicron after public testing.</p><p><strong>Results: </strong>1348 PLHIV and 1 669 389 people without HIV (PWoH) were included. PLHIV were older, more migrant (65 <i>vs.</i> 22%) and male (59 <i>vs.</i> 46%). Of PLHIV, 96% were on antiretroviral treatment and 94% virally suppressed. AdjORs of COVID-19 hospitalisation were similar irrespective of HIV-status, controlled for demographics, calendar month of infection, comorbidities, and income. PLHIV were more likely to be hospitalised than PWoH during Omicron and public testing (adjOR 2.3, 95% CI 1.1-4.2), but not after public testing. The odds of severe COVID-19 were three times higher in PLHIV compared to PWoH vaccinated with 2 doses (adjOR 3.2, 95% CI 1.3-6.9), but not when vaccinated with ≥3 doses (adjOR 0.7, 95% CI 0.2-1.6). Migrant and low nadir CD4<sup>+</sup> T-cells were associated with higher odds of hospitalisation in unvaccinated PLHIV.</p><p><strong>Conclusions: </strong>This nationwide study, including mostly well-treated PLHIV, highlights the importance of vaccination with booster dose/s for effective protection against severe COVID-19 in PLHIV.KEY POINTPeople living with HIV compared to people without HIV did not have higher odds of COVID-19 hospitalisation irrespective of SARS-CoV-2 vaccination status (0-1 dose, 2 doses, ≥3 doses) when adjusting for known risk factors including comorbidities and socioeconomic status.</p>","PeriodicalId":73372,"journal":{"name":"Infectious diseases (London, England)","volume":" ","pages":"1-14"},"PeriodicalIF":0.0000,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Risk of COVID-19 hospitalisation by HIV-status and SARS-CoV-2 vaccination status during pre- and post-Omicron era in a national register-based cohort study in Sweden.\",\"authors\":\"Isabela Killander Möller, Pontus Hedberg, Philippe Wagner, Hannes Lindahl, Sofia Nyström, Lisa Blixt, Sandra Eketorp Sylvan, Åsa Nilsdotter-Augustinsson, Anders Österborg, Mats Fredrikson, Lotta Hansson, Fredrik Kahn, Pär Sparén, Magnus Gisslén, Pontus Nauclér, Peter Bergman, Soo Aleman, Christina Carlander\",\"doi\":\"10.1080/23744235.2024.2405582\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Data on the outcomes of COVID-19 in people living with HIV (PLHIV), specifically in relation to vaccination status, are lacking during the Omicron era.</p><p><strong>Methods: </strong>This nationwide registry-based study included all resident in Sweden ≥18 years with a positive SARS-CoV-2 PCR test during January 2021-February 2023. We estimated adjusted odds ratios (adjOR) for COVID-19 hospitalisation and severe COVID-19 (ICU admission and 90-day mortality), categorised by SARS-CoV-2 vaccination status (0-1, 2, and ≥3 doses), and HIV-status. Analyses were then categorised by time periods of pre-Omicron, Omicron during public testing, and Omicron after public testing.</p><p><strong>Results: </strong>1348 PLHIV and 1 669 389 people without HIV (PWoH) were included. PLHIV were older, more migrant (65 <i>vs.</i> 22%) and male (59 <i>vs.</i> 46%). Of PLHIV, 96% were on antiretroviral treatment and 94% virally suppressed. AdjORs of COVID-19 hospitalisation were similar irrespective of HIV-status, controlled for demographics, calendar month of infection, comorbidities, and income. PLHIV were more likely to be hospitalised than PWoH during Omicron and public testing (adjOR 2.3, 95% CI 1.1-4.2), but not after public testing. The odds of severe COVID-19 were three times higher in PLHIV compared to PWoH vaccinated with 2 doses (adjOR 3.2, 95% CI 1.3-6.9), but not when vaccinated with ≥3 doses (adjOR 0.7, 95% CI 0.2-1.6). Migrant and low nadir CD4<sup>+</sup> T-cells were associated with higher odds of hospitalisation in unvaccinated PLHIV.</p><p><strong>Conclusions: </strong>This nationwide study, including mostly well-treated PLHIV, highlights the importance of vaccination with booster dose/s for effective protection against severe COVID-19 in PLHIV.KEY POINTPeople living with HIV compared to people without HIV did not have higher odds of COVID-19 hospitalisation irrespective of SARS-CoV-2 vaccination status (0-1 dose, 2 doses, ≥3 doses) when adjusting for known risk factors including comorbidities and socioeconomic status.</p>\",\"PeriodicalId\":73372,\"journal\":{\"name\":\"Infectious diseases (London, England)\",\"volume\":\" \",\"pages\":\"1-14\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-09-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Infectious diseases (London, England)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1080/23744235.2024.2405582\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infectious diseases (London, England)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/23744235.2024.2405582","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Risk of COVID-19 hospitalisation by HIV-status and SARS-CoV-2 vaccination status during pre- and post-Omicron era in a national register-based cohort study in Sweden.
Background: Data on the outcomes of COVID-19 in people living with HIV (PLHIV), specifically in relation to vaccination status, are lacking during the Omicron era.
Methods: This nationwide registry-based study included all resident in Sweden ≥18 years with a positive SARS-CoV-2 PCR test during January 2021-February 2023. We estimated adjusted odds ratios (adjOR) for COVID-19 hospitalisation and severe COVID-19 (ICU admission and 90-day mortality), categorised by SARS-CoV-2 vaccination status (0-1, 2, and ≥3 doses), and HIV-status. Analyses were then categorised by time periods of pre-Omicron, Omicron during public testing, and Omicron after public testing.
Results: 1348 PLHIV and 1 669 389 people without HIV (PWoH) were included. PLHIV were older, more migrant (65 vs. 22%) and male (59 vs. 46%). Of PLHIV, 96% were on antiretroviral treatment and 94% virally suppressed. AdjORs of COVID-19 hospitalisation were similar irrespective of HIV-status, controlled for demographics, calendar month of infection, comorbidities, and income. PLHIV were more likely to be hospitalised than PWoH during Omicron and public testing (adjOR 2.3, 95% CI 1.1-4.2), but not after public testing. The odds of severe COVID-19 were three times higher in PLHIV compared to PWoH vaccinated with 2 doses (adjOR 3.2, 95% CI 1.3-6.9), but not when vaccinated with ≥3 doses (adjOR 0.7, 95% CI 0.2-1.6). Migrant and low nadir CD4+ T-cells were associated with higher odds of hospitalisation in unvaccinated PLHIV.
Conclusions: This nationwide study, including mostly well-treated PLHIV, highlights the importance of vaccination with booster dose/s for effective protection against severe COVID-19 in PLHIV.KEY POINTPeople living with HIV compared to people without HIV did not have higher odds of COVID-19 hospitalisation irrespective of SARS-CoV-2 vaccination status (0-1 dose, 2 doses, ≥3 doses) when adjusting for known risk factors including comorbidities and socioeconomic status.
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