![]() This is a study conducted in a cohort of prospectively followed PLWH at the Unit of Infectious Diseases of a university hospital in Seville, Southern Spain. Because of this, we undertook this study, with the purpose of providing insight on the actual incidence, associated factors and clinical outcome of SARS‐CoV‐2 infection in PLWH in Southern Spain. In this manner, the above‐mentioned limitations may be overcome. Serologic studies in which the diagnosis of SARS‐CoV‐2 infection is based on the detection of serum antibodies allow prospective seroincidence analyses, where all infections are accurately identified. ![]() This is a strong limitation for all the aforementioned studies, as milder cases, as well as those in which PCR for SARS‐CoV‐2 was not carried out, could have gone unnoticed. More importantly, within the same cohort of veterans, HIV infection was not a factor related with outcomes (Park LS et al., 2020).Īs with COVID‐19 incidence, the outcome data of SARS‐CoV‐2 infection among PLWH are based on reported clinical cases. On the contrary, propensity‐matched analyses revealed no difference in COVID‐19 outcomes for PLWH, showing that higher mortality is driven by higher burden of comorbidities than in the general population (Hadi et al., 2020). In these two studies, the use of tenofovir diphosphate (TDF) plus emtricitabine (FTC) or lamivudine was associated with a lower risk of severe COVID‐19 (Boulle et al., 2020 Del Amo et al., 2020). In this same regard, HIV infection was associated with approximately a twofold increase in COVID‐19 mortality in a study from South Africa (Boulle et al., 2020). ![]() In fact, after standardization to the age and sex distribution of Spain, the risk of death from COVID‐19 was slightly higher among PLWH than for the Spanish general population during the same period (Del Amo et al., 2020). PLWH, due to premature ageing and comorbidities (Ekong et al., 2020), could be at a higher risk of poorer COVID‐19 outcomes. Similarly, the impact of HIV coinfection on the outcome of SARS‐CoV‐2 infection has not been clearly defined. Thus, whether PLWH are at different risk of acquiring SARS‐CoV‐2 infection or not is currently unknown (Office of AIDS Research Advisory Council, 2021). As in some cases SARS‐CoV‐2 infections are asymptomatic (Pollán et al., 2020) and diagnosis was limited by test shortage and health care system capacity surpassing, the incidence of SARS‐CoV‐2 infection among PLWH could have been underestimated. However, the evaluation of the incidence of SARS‐CoV‐2 infection in PLWH have been based on clinical reports. Several studies suggested that the risk of SARS‐CoV‐2 infection for PLWH is similar to that of general population (Boulle et al., 2020 Braunstein et al., 2020 Del Amo et al., 2020). COVID‐19 cases have been observed among people living with HIV (PLWH) in many countries across the world. The first reported case in the country was diagnosed on9 February 2020 (Ministerio de Sanidad, 2020). SARS‐CoV‐2 infection pandemic has extensively involved Spain, with over 3.2 million confirmed cases by March 2021 after three waves. ![]() In conclusion, the incidence of SARS‐CoV‐2 infection among PLWH in Southern Spain during the ongoing pandemic was lower than that reported for the general population in the same area. After multivariable analysis, adjusted by age, sex, and risk factors for HIV infection, active tobacco use and CDC stage, active tobacco smoking was the only factor independently associated with lower risk of SARS‐Cov‐2 infection. Between 18 May and 29 November 2020, the rate of seroconversion was 5.3% (95% CI: 3.1%–9.0%) for the general population in the area of Seville and 2.3% (95% CI: 1.3%–2.6%) for PLWH in this study ( p = .001). ![]() Of them, 55 patients developed SARS‐CoV‐2 infection. Seven hundred and nine PLWH were included in the study. SARS‐CoV‐2 infections were diagnosed by PCR, antigen detection or serology. Patients were enrolled in the study if (1) they had attended as outpatients our Unit from 1 August 2019 to 8 February 2020 and (2) had two subsequent evaluations from 9 February 2020 to 4 March 2021. This prospective cohort study included PLWH from a Tertiary University Hospital in Southern Spain. Because of this, we evaluated the incidence of associated factors with and the clinical outcome of SARS‐CoV‐2 infection in PLWH in Southern Spain. Prospective serologic studies may allow seroincidence analyses, where all infections are accurately identified. Whether people living with HIV (PLWH) are at greater risk of acquiring SARS‐CoV‐2 infection is currently unknown. ![]()
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