Factors associated with SARS-CoV-2 infection among people living with HIV: Data from the Balearic cohort (EVHIA)

PLoS One. 2024 Aug 7;19(8):e0308568. doi: 10.1371/journal.pone.0308568. eCollection 2024.

Abstract

Introduction: The impact of SARS-CoV-2 infection among people living with HIV (PLWH) has been a matter of research. We evaluated the incidence and factors associated with SARS-CoV-2 diagnosis among PLWH. We also assessed factors related to vaccination coverage in the Balearic Islands.

Methods: A retrospective analytical study was performed, including patients from the Balearic cohort (EVHIA) who were visited at least twice between 1st January 2020 and 31st March 2022. Chi-square test and Mann-Whitney U test were used to compare categorical and continuous variables respectively. Multivariable Cox proportional hazards regression models were estimated to identify risk factors.

Results: A total of 3567 patients with HIV were included. The median age was 51 years (IQR 44-59). Most of them were male (77,3%), from Europe (82,1%) or South America (13,8%). During the study period 1036 patients were diagnosed with SARS-CoV-2 infection (29%). The incidence rate was 153,24 cases per 1000 person-year. After multivariable analysis, men who have sex with men (MSM) were associated with an increased risk of SARS-CoV-2 infection (adjusted hazard ratio 1,324, 95% CI 1,138-1,540), whereas African origin, tobacco use and complete or booster vaccination coverage were negatively related. Overall, complete vaccination or booster coverage was recorded in 2845 (79,75%) patients. When analysing vaccination uptake, older patients (adjusted hazard ratio 5,122, 95% CI 3,170-8,288) and those with a modified comorbidity index of 2-3 points (adjusted hazard ratio 1,492, 95% CI 1,056-2,107) had received more vaccine doses.

Conclusions: In our study no HIV related factor was associated with an increased risk of SARS-CoV-2 infection, except for differences in the transmission route. Possible confounding variables such as mask wearing or social interactions could not be measured. Vaccines were of utmost importance to prevent SARS-CoV-2 infection. Efforts should be made to encourage vaccination in those groups of PLWH with less coverage.

MeSH terms

  • Adult
  • COVID-19* / epidemiology
  • Female
  • HIV Infections* / complications
  • HIV Infections* / epidemiology
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2 / isolation & purification
  • Spain / epidemiology
  • Vaccination Coverage / statistics & numerical data

Grants and funding

The author(s) received no specific funding for this work.