Factors associated with COVID-19 infection in People Living with HIV. A case-control study nested in a Colombian cohort

Objective: People living with HIV (PLWH); can be especially vulnerable to the effects of SARS-Co V-2 and COVID-19. In this study, we evaluate the factors associated with acquiring COVID-19 and the severity of the infection among PLWH. Materials and methods: Through a case-control study nested in a cohort, where cases were PLWH diagnosed with COVID-19; and controls were PLWH without the infection, 476 people were evaluated between May 1, 2020, and February 28, 2021. A univariate analysis was performed with the variables considered candidates. Binary logistic regression models were conducted for the COVID-19 outcome, and among those diagnosed with the infection, regression models for the outcome of hospitalization vs. outpatient treatment. Results: Among 238 PLWH diagnosed with COVID-19, receiving integrase inhibitors p < 0.001 (CI 95% 0.27,0.72) or protease inhibitors p 0.034 (CI 95%0.42,0.97) within their antiretroviral regime, was associated with a lower probability of developing COVID-19. 196 (82,35%) of the 238 cases received outpatient treatment, and 42 (17,64%) required hospitalization. In this case, being older than 50 years p < 0.001 (CI 95% 1.8,9.64) and having obesity as a comorbidity p 0.017 (CI 95% 1.34,17.93) increased the possibility of requiring hospitalization, while receiving antiretroviral treatment or having received vaccination against influenza, decreased the likelihood of this outcome. Conclusions: There are still many questions regarding whether there is a differential risk of acquiring COVID-19 among PLWH. Antiretroviral treatment with integrase or protease inhibitors; was associated with a lower probability of developing the co-infection. Some factors related to comorbidities, such as older age and obesity, draw attention to possible risk factors for hospitalization in this population. Discussing the feasibility of new studies with proposed causal hypotheses that allow directing the research designs toward a more precise answer to these questions is essential.