SARS-CoV-2 Testing and Positivity Among Persons With and Without HIV in 6 US Cohorts.

Park LS, McGinnis KA, Gordon KS, Justice AC, Leyden W, Silverberg MJ, Skarbinski J, Jefferson C, Horberg M, Certa J, Napravnik S, Edwards JK, Westreich D, Bastarache L, Gangireddy S, Benning L, D'Souza G, Williams C, Althoff KN, CIVET Collaboration of the NA-ACCORD of IeDEA. SARS-CoV-2 Testing and Positivity Among Persons With and Without HIV in 6 US Cohorts. Journal of acquired immune deficiency syndromes (1999). 2022 Jul 1; 90(3):249-255.

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Abstract:

BACKGROUND: It is not definitively known if persons with HIV (PWH) are more likely to be SARS-CoV-2 tested or test positive than persons without HIV (PWoH). We describe SARS-CoV-2 testing and positivity in 6 large geographically and demographically diverse cohorts of PWH and PWoH in the United States. SETTING: The Corona Infectious Virus Epidemiology Team comprises 5 clinical cohorts within a health system (Kaiser Permanente Northern California, Oakland, CA; Kaiser Permanente Mid-Atlantic States, Rockville, MD; University of North Carolina Health, Chapel Hill, NC; Vanderbilt University Medical Center, Nashville, TN; and Veterans Aging Cohort Study) and 1 interval cohort (Multicenter AIDS Cohort Study/Women''s Interagency HIV Study Combined Cohort Study). METHODS: We calculated the proportion of patients SARS-CoV-2 tested and the test positivity proportion by HIV status from March 1 to December 31, 2020. RESULTS: The cohorts ranged in size from 1675 to 31,304 PWH and 1430 to 3,742,604 PWoH. The proportion of PWH who were tested for SARS-CoV-2 (19.6%-40.5% across sites) was significantly higher than PWoH (14.8%-29.4%) in the clinical cohorts. However, among those tested, the proportion of patients with positive SARS-CoV-2 tests was comparable by HIV status; the difference in proportion of SARS-CoV-2 positivity ranged from 4.7% lower to 1.4% higher. CONCLUSIONS: Although PWH had higher testing proportions compared with PWoH, we did not find evidence of increased positivity in 6 large, diverse populations across the United States. Ongoing monitoring of testing, positivity, and COVID-19-related outcomes in PWH are needed, given availability, response, and durability of COVID-19 vaccines; emergence of SARS-CoV-2 variants; and latest therapeutic options.