COVID-19 breakthrough infections among people living with and without HIV: A statewide cohort analysis.
COVID-19 breakthrough infections among people living with and without HIV: A statewide cohort analysis.
复制标题
HIV 感染者和未感染者中的 COVID-19 突破性感染：全州范围的队列分析。
DOI：
10.1016/j.ijid.2023.11.029
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发表时间：
2024
期刊：
影响因子：
--
通讯作者：
Li,Xiaoming
中科院分区：
文献类型：
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作者：
Yang,Xueying;Zhang,Jiajia;Liu,Ziang;Chen,Shujie;Olatosi,Bankole;Poland,GregoryA;Weissman,Sharon;Li,Xiaoming
本研究旨在描述和比较在大流行不同阶段艾滋病毒感染者和非艾滋病毒感染者之间的COVID-19突破性感染。方法使用全州范围内的HIV队列数据，研究人群包括南卡罗来纳州（SC）的成年居民（bb0 - 18岁），他们在2021年1月2日至2022年4月14日期间完全接种了疫苗，当时Alpha， Delta和Omicron变体在SC中流行。我们使用Cox比例风险模型来调查HIV感染与突破感染之间的关系，并调整相关的共变量。结果在2144415名接种者中，HIV感染者（PLWH）为8335人，非HIV感染者（PWoH）为2136080人。倾向评分匹配后，HIV感染与突破感染率无显著相关。然而，当比较没有任何加强剂量的个体之间的突破感染时，PLWH具有更高的突破感染风险（调整危险比：1.19；95%置信区间：1.03-1.39）。与PWoH相比，具有高水平CD4计数或病毒抑制的PLWH与突破性感染无关。我们的研究结果并不支持PLWH中COVID-19疫苗有效性较低的广泛结论，但我们确实发现如果PLWH未接受加强剂量，则与PWoH相比，PLWH具有更高的突破性感染风险。
ObjectivesThis study aims to characterize and compare COVID-19 breakthrough infections between people living with and without HIV across different phases of the pandemic.MethodsUsing statewide HIV cohort data, the study population included adult residents in South Carolina (SC) (>18 years old) who were fully vaccinated between January 02, 2021 and April 14, 2022 when Alpha, Delta, and Omicron variants were circulating in SC. We used the Cox proportional hazard model to investigate the association between HIV infection and breakthrough infection, adjusting for relevant covariates.ResultsAmong 2,144,415 vaccinated individuals, 8,335 were people living with HIV (PLWH) and 2,136,080 were people without HIV (PWoH). After propensity score matching, HIV infection was not significantly associated with breakthrough infection rate. However, when comparing breakthrough infections among individuals without any booster dose, PLWH had a higher risk of breakthrough infections (adjusted Hazard Ration: 1.19; 95% confidence interval: 1.03-1.39). Compared to PWoH, PLWH with high levels of clusters of differentiation 4 (CD4) count or viral suppression were not associated with breakthrough infections.ConclusionsOur findings do not support a broad conclusion that COVID-19 vaccine effectiveness is lower among PLWH, while we did find that PLWH had a higher risk of breakthrough infection compared to PWoH if they did not receive a booster dose.