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

• Published in: International journal of infectious diseases 2020-11, Vol.100, p.141-148
• Main Authors: Liu, Jia, Zeng, Wenjuan, Cao, Yukun, Cui, Yue, Li, Yumin, Yao, Sheng, Alwalid, Osamah, Yang, Fan, Fan, Yanqing, Shi, Heshui
• Format: Article
• Language: English
• Subjects: Adult; Anti-Retroviral Agents - therapeutic use; Antiretroviral therapy; Betacoronavirus; Characteristics; Coinfection - complications; Coinfection - drug therapy; Coronavirus disease 2019; Coronavirus Infections - complications; COVID-19; Female; HIV; HIV Infections - drug therapy; Humans; Length of Stay; Male; Middle Aged; Pandemics; Pneumonia, Viral - complications; Retrospective Studies; Reverse transcription-polymerase chain reaction; SARS-CoV-2; Serum antibodies
• ISSN: 1201-9712; 1878-3511
• DOI: 10.1016/j.ijid.2020.08.045

•Compared with SARS-CoV-2 infected general population, patients with HIV co-infection mostly have milder clinical presentation.•A single test of viral RNA test and antibodies against SARS-CoV-2 might be insufficient to exclude COVID-19 infection in patients with HIV.•The milder extent of inflammatory response to SARS-CoV-2 infection might be associated with a previous history of ART in HIV-infected patients. 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. 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. 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). 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.