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Review Article
Human immunodeficiency virus and mortality from coronavirus disease 2019: A systematic review and meta-analysis
Submitted: 26 January 2021 | Published: 15 April 2021
About the author(s)
Timotius I. Hariyanto, Faculty of Medicine, Pelita Harapan University, Tangerang, IndonesiaJane Rosalind, Faculty of Medicine, Pelita Harapan University, Tangerang, Indonesia
Kevin Christian, Faculty of Medicine, Pelita Harapan University, Tangerang, Indonesia
Andree Kurniawan, Department of Internal Medicine, Faculty of Medicine, Pelita Harapan University, Tangerang, Indonesia
Abstract
Background: Persons living with human immunodeficiency virus (PLWH) constitute a vulnerable population in view of their impaired immune status. At this time, the full interaction between HIV and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been incompletely described.
Objective: The purpose of this study was to explore the impact of HIV and SARS-CoV-2 co-infection on mortality.
Method: We systematically searched PubMed and the Europe PMC databases up to 19 January 2021, using specific keywords related to our aims. All published articles on coronavirus disease 2019 (COVID-19) and HIV were retrieved. The quality of the studies was evaluated using the Newcastle–Ottawa Scale for observational studies. Statistical analysis was performed with Review Manager version 5.4 and Comprehensive Meta-Analysis version 3 software.
Results: A total of 28 studies including 18 255 040 COVID-19 patients were assessed in this meta-analysis. Overall, HIV was associated with a higher mortality from COVID-19 on random-effects modelling {odds ratio [OR] = 1.19 [95% confidence interval (CI) = 1.01–1.39], p = 0.03; I2 = 72%}. Meta-regression confirmed that this association was not influenced by age (p = 0.208), CD4 cell count (p = 0.353) or the presence of antiretroviral therapy (ART) (p = 0.647). Further subgroup analysis indicated that the association was only statistically significant in studies from Africa (OR = 1.13, p = 0.004) and the United States (OR = 1.30, p = 0.006).
Conclusion: Whilst all persons ought to receive a SARS-CoV-2 vaccine, PLWH should be prioritised to minimise the risk of death because of COVID-19. The presence of HIV should be regarded as an important risk factor for future risk stratification of COVID-19.
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