Racial and ethnic disparities in coronavirus disease 2019 disease incidence independent of comorbidities, among people with HIV in the United States.
Journal
AIDS (London, England)
ISSN: 1473-5571
Titre abrégé: AIDS
Pays: England
ID NLM: 8710219
Informations de publication
Date de publication:
01 07 2022
01 07 2022
Historique:
entrez:
7
7
2022
pubmed:
8
7
2022
medline:
12
7
2022
Statut:
ppublish
Résumé
To define the incidence of clinically detected coronavirus disease 2019 (COVID-19) in people with HIV (PWH) in the United States and evaluate how racial and ethnic disparities, comorbidities, and HIV-related factors contribute to risk of COVID-19. Observational study within the CFAR Network of Integrated Clinical Systems cohort in seven cities during 2020. We calculated cumulative incidence rates of COVID-19 diagnosis among PWH in routine care by key characteristics including race/ethnicity, current and lowest CD4+ cell count, and geographic area. We evaluated risk factors for COVID-19 among PWH using relative risk regression models adjusted with disease risk scores. Among 16 056 PWH in care, of whom 44.5% were black, 12.5% were Hispanic, with a median age of 52 years (IQR 40-59), 18% had a current CD4+ cell count less than 350 cells/μl, including 7% less than 200; 95.5% were on antiretroviral therapy (ART), and 85.6% were virologically suppressed. Overall in 2020, 649 PWH were diagnosed with COVID-19 for a rate of 4.94 cases per 100 person-years. The cumulative incidence of COVID-19 was 2.4-fold and 1.7-fold higher in Hispanic and black PWH respectively, than non-Hispanic white PWH. In adjusted analyses, factors associated with COVID-19 included female sex, Hispanic or black identity, lowest historical CD4+ cell count less than 350 cells/μl (proxy for CD4+ nadir), current low CD4+ : CD8+ ratio, diabetes, and obesity. Our results suggest that the presence of structural racial inequities above and beyond medical comorbidities increased the risk of COVID-19 among PWH. PWH with immune exhaustion as evidenced by lowest historical CD4+ cell count or current low CD4+ : CD8+ ratio had greater risk of COVID-19.
Identifiants
pubmed: 35796731
doi: 10.1097/QAD.0000000000003223
pii: 00002030-202207010-00005
pmc: PMC9273020
mid: NIHMS1786423
doi:
Types de publication
Journal Article
Observational Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1095-1103Subventions
Organisme : NIAID NIH HHS
ID : P30 AI027767
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI094189
Pays : United States
Organisme : NIAID NIH HHS
ID : K23 AI140918
Pays : United States
Organisme : NIAID NIH HHS
ID : R24 AI067039
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI027763
Pays : United States
Organisme : NIDA NIH HHS
ID : R01 DA047045
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI060354
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI036219
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI050410
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI036214
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI027757
Pays : United States
Commentaires et corrections
Type : UpdateOf
Informations de copyright
Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.
Références
Anxiety Stress Coping. 2021 Mar;34(2):121-129
pubmed: 32960675
Clin Infect Dis. 2021 Jan 23;72(1):9-14
pubmed: 33035296
Ann Epidemiol. 2020 Jul;47:37-44
pubmed: 32419766
BMJ Evid Based Med. 2021 Dec;26(6):279-284
pubmed: 32788164
Pharmacoepidemiol Drug Saf. 2013 Feb;22(2):122-9
pubmed: 23172692
Lancet HIV. 2021 Nov;8(11):e690-e700
pubmed: 34655550
Clin Infect Dis. 2012 Jan 1;54(1):141-7
pubmed: 22042879
J Acquir Immune Defic Syndr. 2021 Mar 1;86(3):297-304
pubmed: 33351530
Am J Epidemiol. 2004 Apr 1;159(7):702-6
pubmed: 15033648
J Infect Dis. 2020 Oct 13;222(10):1592-1595
pubmed: 32729903
Clin Infect Dis. 2021 Oct 5;73(7):e2005-e2015
pubmed: 32860699
Am J Epidemiol. 2011 Sep 1;174(5):613-20
pubmed: 21749976
Cell Mol Immunol. 2020 May;17(5):541-543
pubmed: 32203186
JAMA. 2019 Jul 9;322(2):113-114
pubmed: 31169890
Am J Gastroenterol. 2010 Jun;105(6):1346-53
pubmed: 20179698
J Acquir Immune Defic Syndr. 2022 Aug 1;90(4):369-376
pubmed: 35364600
Curr Opin HIV AIDS. 2021 Jan;16(1):63-73
pubmed: 33186229
AIDS Patient Care STDS. 2012 Feb;26(2):73-80
pubmed: 22239101
J Int AIDS Soc. 2020 Nov;23(11):e25639
pubmed: 33222424
JAMA Netw Open. 2020 Sep 1;3(9):e2019933
pubmed: 32975568
Am Psychol. 2013 May-Jun;68(4):197-209
pubmed: 23688088
Circulation. 2014 Jun 24;129(25 Suppl 2):S49-73
pubmed: 24222018
Lancet HIV. 2021 Jan;8(1):e24-e32
pubmed: 33316211
MMWR Morb Mortal Wkly Rep. 2020 Aug 21;69(33):1133-1138
pubmed: 32817604
J Infect Dis. 2020 Aug 17;222(6):890-893
pubmed: 32599614
J Community Health. 2017 Oct;42(5):844-853
pubmed: 28247067
Pharmacoepidemiol Drug Saf. 2019 Feb;28(2):140-147
pubmed: 29923258
Nat Commun. 2020 Nov 12;11(1):5749
pubmed: 33184277
Curr HIV Res. 2006 Jan;4(1):97-106
pubmed: 16454715
Diabetes Care. 2021 Sep;44(9):1916-1923
pubmed: 34244333
Ann Epidemiol. 2020 Dec;52:46-53.e2
pubmed: 32711053
J Infect Dis. 2021 Dec 1;224(11):1810-1820
pubmed: 34323998
MMWR Morb Mortal Wkly Rep. 2016 Feb 05;65(4):77-82
pubmed: 26844978
Clin Infect Dis. 2021 Jun 15;72(12):e1021-e1029
pubmed: 33252620
Healthcare (Basel). 2021 Feb 02;9(2):
pubmed: 33540498
AIDS Behav. 2021 Jan;25(1):1-8
pubmed: 32918640
J Public Health Manag Pract. 2021 Jan/Feb;27 Suppl 1, COVID-19 and Public Health: Looking Back, Moving For:S39-S42
pubmed: 33239562
J Acquir Immune Defic Syndr. 2016 Aug 1;72(4):437-43
pubmed: 26990826
Ann Intern Med. 2009 May 5;150(9):604-12
pubmed: 19414839
Spat Spatiotemporal Epidemiol. 2020 Aug;34:100355
pubmed: 32807400
Obes Rev. 2020 Nov;21(11):e13128
pubmed: 32845580
AIDS Patient Care STDS. 2020 Oct;34(10):417-424
pubmed: 32833494
Int J Epidemiol. 2008 Oct;37(5):948-55
pubmed: 18263650