COVID-19 Vaccination Lowers PASC Risk in People With HIV
Vaccination for COVID-19 significantly lowers mortality and protects against post-acute sequelae of SARS-CoV2 (PASC) among people living with HIV (PWH), according to the results of a recent study presented at the 2023 Conference on Retroviruses and Opportunistic Infections.
To better understand the relationship between vaccination and PASC risk in this patient population, researchers utilized the TriNetX health research database. Data from more than 3 million adults who tested positive for COVID-19 from January 2020 to September 16, 2022 from 69 health care organizations in the United States were included.
After matching for HIV and vaccination status, the primary measure was the risk of PASC, which was defined here as either the persistence of COVID-related symptoms or new-onset health conditions at least 28 days after a COVID-19 diagnosis.
A total of 28,904 individuals with both HIV and COVID-19 were identified, with 9% (n = 2592) of these patients having been vaccinated. The risk of PASC was found to be higher during the pre-Delta variant period. However, this risk did not vary based on CD4 count or HIV viremia.
The results indicated that PWH had lower mortality when compared with those without HIV after a COVID-19 diagnosis (odds ratio [OR] = 0.78; 95% CI, 0.70-0.87). Additionally, PWH who were vaccinated had significantly lower odds of death (OR = 0.63; 95% CI, 0.42-0.93).
When compared with those without HIV, PWH had a higher risk of developing new-onset health conditions at 28 days following diagnosis (Table 1). Vaccinated PWH had significantly lower odds of these new-onset PASC outcomes (Table 2).
Conditions | PWH | HIV- | OR (95% CI) |
Diabetes | 3% | 1% | 1.26 (1.11-1.42) |
Heart disease | 5% | 2% | 1.27 (1.14-1. 41) |
Malignancy | 3% | 1% | 1.66 (1.45-1.89) |
Thrombosis | 3% | 1% | 1.25 (1.12-1.39) |
Mental disorders | 9% | 3% | 1.70 (1.53-1.90) |
Table 1. PASC risk for PWH compared to those without HIV.
Conditions | PWH vaccinated | PWH Unvaccinated | OR (95% CI) |
Diabetes | 2% | 4% | 0.51 (0.32-0.82) |
Heart disease | 3% | 7% | 0.44 (0.29-0.67) |
Malignancy | 2% | 4% | 0.43 (0.25-0.74) |
Thrombosis | 2% | 6% | 0.51 (0.33-0.78) |
Mental disorders | 5% | 9% | 0.49 (0.30-0.79) |
Table 2. PWH who are vaccinated vs PWH are who are unvaccinated.
“HIV infection confers a higher risk of PASC. Importantly, COVID-19 vaccination significantly lowered mortality and was protective against PASC among PWH,” the researchers concluded. “With the increase in the number of COVID-19 survivors, vaccination offers an effective preventive strategy to address a burgeoning public health problem.”
Reference:
Yendewa GA, Perez JA, Patil NT, McComsey GA. HIV infection increases risk of PASC while COVID-19 vaccination is protective. Poster presented at: Conference on Retroviruses and Opportunistic Infections; February 19-22, 2023; Seattle, WA. Accessed March 22, 2023. https://www.croiconference.org/abstract/hiv-infection-increases-risk-of-pasc-while-covid-19-vaccination-is-protective/