Evaluation of the Interplay between HIV and COVID-19 in a large urban safety-net HIV clinic

大型城市安全网 HIV 诊所中 HIV 和 COVID-19 之间相互作用的评估

• 批准号: 10669735
• 负责人: Monica Gandhi
• 金额: $ 79.85万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10669735
• 关键词: 1918 influenza pandemic; 2019-nCoV; Adherence; Africa; Age; Anti-Retroviral Agents; Antibody Response; Anxiety; Area; Attenuated; COVID-19; COVID-19 impact; COVID-19 pandemic; COVID-19 risk; COVID-19 susceptibility; Cardiovascular Diseases; Caring; Cessation of life; Chronic Disease; Cities; Clinic; Clinical; Clinical Investigator; Communicable Diseases; Country; Data; Diabetes Mellitus; Disease; Disease Outbreaks; Ebola; Emergency department visit; Enrollment; Epidemic; Epidemiologist; Evaluation; Frequencies; Grant; HIV; HIV Infections; Health; Health system; Healthcare; Healthcare Systems; Height; High Prevalence; Hospitalization; Housing; Human immunodeficiency virus test; Hypertension; Immune response; Impairment; Incidence; Individual; Infection; Inpatients; Intervention; Laboratories; Link; Low income; Lung diseases; Measures; Medical; Mental Depression; Mental disorders; Methods; Neighborhoods; Occupational Health; Outcome; Patients; Persons; Pharmaceutical Preparations; Population; Prevalence; Procedures; Prospective cohort; Protease Inhibitor; Provider; Public Health; Pulmonary function tests; RNA; Regimen; Registries; Reporting; Research; Research Infrastructure; Respiratory Disease; Risk; Risk Factors; SARS-CoV-2 exposure; SARS-CoV-2 immune response; SARS-CoV-2 immunity; SARS-CoV-2 infection; SARS-CoV-2 transmission; San Francisco; Scientist; Services; Severity of illness; Shelter facility; Site; Social Behavior; Social Distance; Social Work; Social isolation; Social support; Speed; Stress; Support System; System; T cell response; T-Lymphocyte; Telephone; Tenofovir; United States; Viral; Viral Load result; Virus; Visit; Vulnerable Populations; aging population; antiretroviral therapy; behavioral outcome; care systems; co-infection; cohort; community transmission; comorbidity; coronavirus disease; experience; food insecurity; future pandemic; health care service utilization; human old age (65+); immune activation; infection rate; infection risk; insight; marginally housed; novel; pandemic disease; pandemic impact; patient retention; post SARS-CoV-2 infection; post-COVID-19; public health emergency; public health relevance; remote visit; resilience; response; safety net; school closure; serosurvey; severe COVID-19; sex; social stigma; substance use; testing services; therapeutic development; transmission process; urgent care; vaccine development; ward

PROJECT SUMMARY/ ABSTRACT An unprecedented public health emergency due to the COVID-19 pandemic is unfolding worldwide and the United States has been the epicenter of the pandemic since March 26, 2020. No prior global pandemic of this scale has overlapped temporally with the HIV pandemic. Despite this, given the breathtaking speed at which the pandemic has progressed, very little is known about the interplay between HIV and SARS-CoV-2 given that COVID-19 has only recently entered areas of high HIV prevalence. The COVID-19 pandemic is threatening worldwide gains in UNAIDS 90:90:90 targets for HIV by disrupting health systems, economies, and the health of people with HIV. San Francisco was the first city in the U.S. to impose “shelter in place” public health measures on March 16, 2020. Given the need to limit in-person visits to counter the spread of COVID-19, research on the impact on HIV outcomes, retention in care, and sociobehavioral outcomes will be crucial to develop interventions to attenuate COVID-19's deleterious impact and to plan for future pandemics. Whether people with HIV (PWH) are more or less susceptible to COVID-19 or severe disease is unknown; some of the risk factors for severe COVID-19 (older age, cardiovascular disease, pulmonary disease) are more prevalent among PWH but HIV medications such as tenofovir and its metabolites could be protective. PWH in low-income settings have marginal housing and food insecurity, increasing transmission risk. Given the impact of HIV on immune responses, it is also important to understand if PWH will have less durable immunity against COVID-19 following infection. Finally, the impact of the COVID-19's disruption of medical and social services for PWH needs urgent study, both during the crisis and in its aftermath, since COVID-19 has the potential to eradicate the progress made on Ending the HIV Epidemic to date. This proposal will answer three vital questions concerning the interplay between the two viruses. The site of the study will be at the Ward 86 HIV Clinic, a large safety-net clinic for publicly-insured patients with HIV in San Francisco, near the neighborhoods experiencing concentrated COVID-19 epidemics. Aim 1 will provide novel, urgently needed insights into how SARS-CoV-2 infection risk, prevalence and clinical outcomes vary by HIV status and/or antiretroviral regimen (i.e. tenofovir). Aim 2 will explore whether HIV infection will impair humoral or T-cell responses to COVID-19, providing insights for therapeutic and vaccine development. Aim 3 data will evaluate the impact of disruption of healthcare and social support systems on PWH, including viral suppression; retention in care; hospitalizations, co-morbidity outcomes, and non-COVID-19 related death; healthcare utilization during COVID019; and socio-behavioral outcomes during and after social distancing to assess isolation, food insecurity, stress, substance use, stigma, and resilience. Harnessing, the research infrastructure of the UCFAR, citywide COVID-19 registries, and a large, aging population of PWH served by the Ward 86 clinic, this grant will put immediate, high-impact studies in place to track the colliding pandemics.

项目摘要/摘要

项目成果

The intertwined epidemics of HIV and COVID-19 - emerging data and responses.

HIV 和 COVID-19 相互交织的流行病 - 新出现的数据和应对措施。

• DOI: 10.1097/coh.0000000000000792
• 发表时间: 2023
• 期刊: Current opinion in HIV and AIDS
• 影响因子: 4.1
• 作者: Spinelli,Matthew;Gandhi,Monica;Riva,Agostino
• 通讯作者: Riva,Agostino

Long COVID manifests with T cell dysregulation, inflammation and an uncoordinated adaptive immune response to SARS-CoV-2.

• DOI: 10.1038/s41590-023-01724-6
• 发表时间: 2024-02
• 期刊: NATURE IMMUNOLOGY
• 影响因子: 30.5
• 作者: Yin, Kailin;Peluso, Michael J.;Luo, Xiaoyu;Thomas, Reuben;Shin, Min-Gyoung;Neidleman, Jason;Andrew, Alicer;Young, Kyrlia C.;Ma, Tongcui;Hoh, Rebecca;Anglin, Khamal;Huang, Beatrice;Argueta, Urania;Lopez, Monica;Valdivieso, Daisy;Asare, Kofi;Deveau, Tyler-Marie;Munter, Sadie E.;Ibrahim, Rania;Staendker, Ludger;Lu, Scott;Goldberg, Sarah A.;Lee, Sulggi A.;Lynch, Kara L.;Kelly, J. Daniel;Martin, Jeffrey N.;Muench, Jan;Deeks, Steven G.;Henrich, Timothy J.;Roan, Nadia R.
• 通讯作者: Roan, Nadia R.

SARS-CoV-2 vaccination in people with HIV.

• DOI: 10.1016/s2352-3018(21)00128-4
• 发表时间: 2021-08
• 期刊: The lancet. HIV
• 作者: Spinelli MA

COVID-19 Outcomes and Risk Factors Among People Living with HIV.

• DOI: 10.1007/s11904-022-00618-w
• 发表时间: 2022-10
• 期刊: Current HIV/AIDS reports
• 影响因子: 4.6

Importance of non-pharmaceutical interventions in lowering the viral inoculum to reduce susceptibility to infection by SARS-CoV-2 and potentially disease severity.

• DOI: 10.1016/s1473-3099(20)30982-8
• 发表时间: 2021-09
• 期刊: The Lancet. Infectious diseases
• 作者: Spinelli MA;Glidden DV;Gennatas ED;Bielecki M;Beyrer C;Rutherford G;Chambers H;Goosby E;Gandhi M
• 通讯作者: Gandhi M