Effect of a Previous History of Antiretroviral Treatment on Clinical Picture of Patients with Co-infection of SARS-CoV-2 and HIV: A Preliminary Study

Int J Infect Dis. 2020 Nov:100:141-148. doi: 10.1016/j.ijid.2020.08.045. Epub 2020 Aug 20.

Abstract

Objectives: We aimed to explore the effect of antiretroviral treatment (ART) history on clinical characteristics of patients with co-infection of SARS-CoV-2 and HIV.

Methods: We retrospectively reviewed 20 patients with laboratory-confirmed co-infection of SARS-CoV-2 and HIV in a designated hospital. Patients were divided into medicine group (n = 12) and non-medicine group (n = 8) according to previous ART history before SARS-CoV-2 infection.

Results: The median age was 46.5 years and 15 (75%) were female. Ten patients had initial negative RT-PCR on admission, 5 of which had normal CT appearance and 4 were asymptomatic. Lymphocytes were low in 9 patients (45%), CD4 cell count and CD4/CD8 were low in all patients. The predominant CT features in 19 patients were multiple (42%) ground-glass opacities (58%) and consolidations (32%). Erythrocyte sedimentation rate (ESR) in the medicine group was significantly lower than that in the non-medicine group [median (interquartile range, IQR):14.0 (10.0-34.0) vs. 51.0 (35.8-62.0), P = 0.005]. Nineteen patients (95%) were discharged with a median hospital stay of 30 days (IQR, 26-30).

Conclusions: Most patients with SARS-CoV-2 and HIV co-infection exhibited mild to moderate symptoms. The milder extent of inflammatory response to SARS-CoV-2 infection might be associated with a previous history of ART in HIV-infected patients.

Keywords: HIV; antiretroviral therapy; characteristics; coronavirus disease 2019; reverse transcription-polymerase chain reaction; serum antibodies.

MeSH terms

  • Adult
  • Anti-Retroviral Agents / therapeutic use*
  • Betacoronavirus*
  • COVID-19
  • Coinfection / complications*
  • Coinfection / drug therapy
  • Coronavirus Infections / complications*
  • Female
  • HIV Infections / drug therapy*
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / complications*
  • Retrospective Studies
  • SARS-CoV-2

Substances

  • Anti-Retroviral Agents