Asymptomatic SARS-CoV-2 Infection is Extremely Common Among People with HIV

JAIDS, August 2022.

Despite the emergence of the COVID-19 pandemic, the REPRIEVE Trial adapted study visits to facilitate ongoing follow up at the 100+ sites located around the globe. The REPRIEVE team recognized a unique opportunity to evaluate the intersection between these two viral pathogens with a specific focus on the effects on atherosclerotic cardiovascular disease (ASCVD) in the setting of HIV. To characterize the emergence of the COVID-19 pandemic, the study team added more blood collection to study visits to measure SARS-CoV-2 virus antibodies and added surveys to collect information about participant symptoms related to COVID-19. These data will provide the opportunity to understand how co-infection with SARS-CoV-2 virus impacts ASCVD among people with HIV.

Between May 2020 and February 2021, 2,464 REPRIEVE participants had completed annual visits that included completion of the surveys and collection of blood to perform testing for evidence of SARS-CoV-2 infection.

The population included in the analysis were similar to the overall REPRIEVE cohort with a median age of 53 years, 35% female, 47% Black, average CD4 cell count 649 cells per cubic millimeter, and 97% with suppressed HIV. From the cohort, there were 304 people with evidence of SARS-CoV-2 infection who also completed the survey data. Notably, 121 individuals reported a symptomatic infection but 183 (60%) reported no symptoms of their infection.

These results have been very informative to the field of medicine. They reinforce that asymptomatic SARS-CoV-2 infection is common in people living with HIV. The 60% reported asymptomatic rate is higher than previously reported in HIV cohorts where less than 50% of people living with HIV were asymptomatic. In fact, these numbers are similar to what has been reported in the general population. These findings reinforce the importance of aggressive prevention efforts to keep people living with HIV healthy, including providing access to COVID-19 vaccines and educating patients about preventive measures to maintain their health. As the COVID-19 pandemic evolves with new strains of the SARS-CoV-2 virus and improving treatments, we must remain vigilant to provide optimal care to people living with HIV.

The study team expects that REPRIEVE will provide a unique opportunity to evaluate the effects of SARS-CoV-2 virus infection on ASCVD among people living with HIV.

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