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Global and Regional Prevalence and Outcomes of COVID-19 in People Living with HIV: A Systematic Review and Meta-Analysis

Oyelade, Tope; Alqahtani, Jaber S; Hjazi, Ahmed M; Li, Amy; Kamila, Ami; Raya, Reynie Purnama; (2022) Global and Regional Prevalence and Outcomes of COVID-19 in People Living with HIV: A Systematic Review and Meta-Analysis. Tropical Medicine and Infectious Disease , 7 (2) , Article 22. 10.3390/tropicalmed7020022. Green open access

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Abstract

BACKGROUND: The relationship between HIV (human immunodeficiency virus) and COVID-19 clinical outcome is uncertain, with conflicting data and hypotheses. We aimed to assess the prevalence of people living with HIV (PLWH) among COVID-19 cases and whether HIV infection affects the risk of severe COVID-19 or related death at the global and continental level. METHODS: Electronic databases were systematically searched in July 2021. In total, 966 studies were screened following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Narratives were synthesised and data pooled for the global and continental prevalence of HIV-SARS-CoV-2 coinfection. The relative risks of severity and mortality in HIV-infected COVID-19 patients were computed using a random-effect model. Risk of bias was assessed using the Newcastle-Ottawa score and Egger's test, and presented as funnel plots. RESULTS: In total, 43 studies were included involving 692,032 COVID-19 cases, of whom 9097 (1.3%) were PLWH. The global prevalence of PLWH among COVID-19 cases was 2% (95% CI = 1.7-2.3%), with the highest prevalence observed in sub-Saharan Africa. The relative risk (RR) of severe COVID-19 in PLWH was significant only in Africa (RR = 1.14, 95% CI = 1.05-1.24), while the relative risk of mortality was 1.5 (95% CI = 1.45-2.03) globally. The calculated global risk showed that HIV infection may be linked with increased COVID-19 death. The between-study heterogeneity was significantly high, while the risk of publication bias was not significant. CONCLUSIONS: Although there is a low prevalence of PLWH among COVID-19 cases, HIV infection may increase the severity of COVID-19 in Africa and increase the risk of death globally.

Type: Article
Title: Global and Regional Prevalence and Outcomes of COVID-19 in People Living with HIV: A Systematic Review and Meta-Analysis
Location: Switzerland
Open access status: An open access version is available from UCL Discovery
DOI: 10.3390/tropicalmed7020022
Publisher version: https://doi.org/10.3390/tropicalmed7020022
Language: English
Additional information: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
Keywords: COVID-19; HIV; public health; pandemic; infectious disease
UCL classification: UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Surgical Biotechnology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
URI: https://discovery.ucl.ac.uk/id/eprint/10146065
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