Table 2.
Summary of studies reporting outcomes by antiretroviral therapy regimen and other risk factors for adverse coronavirus disease 2019 outcomes among people living with HIV.
| Study | Influence of ART regimens | Other risk factors among PLWH |
| Boulle et al.[20], n = 3978 | Lower mortality in patients on TDF vs. abacavir/zidovudine (aHR: 0.42; 95% CI: 0.22; 0.78) | 601 patients had CD4+ cell count measured during episode of COVID-19. Higher mortality associated with CD4+ cell counts <200 cells/μl (n = 70) vs. ≥350 cells/μl (aHR 1.97; 95% CI 1.14–3.40). Direction of causality unclearNo difference in hazard of COVID-19 death by HIV VL (aHR vs. HIV-negative: 2.61 (95% CI: 1.98–3.43) for VL < 1000 copies/ml; 3.35 (95% CI: 1.38–6.12) for VL ≥ 1000 copies/ml or CD4+ cell count <200 cells/μl) |
| Bhaskaran et al.[22]Number of PLWH & COVID-19 not presented | N/A | PLWH of Black ethnicity had higher risk of COVID-19 mortality (aHR 4.31, P for interaction 0.044). No data on outcomes by CD4+ or VL |
| del Amo et al.[13], n = 236 | Lowest risk for COVID-19 diagnosis [16.9% (95% CI: 10.5–25.9) & hospitalization 10.5 (95% CI: 5.6–17.9)] in PLWH receiving TDF/FTC compared with other ART regimens [e.g. ABC/3TC 28.3% (95% CI: 21.5–36.7) and 23.4% (95% CI: 17.2–31.1) respectively] | Higher crude risk of COVID-19 death among older PLWH [70–79 years = 26.6/10 000, 95% (CI: 10.7–54.9) vs. 50–59 years 2.2/10 000 (95% CI: 10.7–54.9)]. No difference by sex |
| Ho et al.[24], n = 93 | No significant difference in TDF use between PLWH with COVID-19 who survived and died (73.6 vs. 55.5%, P = 0.15) | No significant differences in obesity, CD4+ cell counts or HIV VL between PLWH with COVID-19 who survived and died |
| Di Biagio et al.[25], n = 69 | No stat. sig. association between risk of hospitalization and ART regimens | Hospitalized PLWH were slightly older (P = 0.047). No association between most recent VL or CD4+ cell count and hospitalization |
| Maggiolo et al.[26], n = 55 | No difference in TDF use among PLWH with COVID-19 (60%) vs. without COVID-19 (60.8%) | 4 PLWH with COVID-19 who died had lower last CD4+ cell count (median 514 cells/μl) than the 51 PLWH who survived (median 913 cells/μl) |
| Etienne et al.[27], n = 54 | No stat. sig. difference between ART regimen and COVID-19 severity | No stat. sig. association between CD4+ cell counts or VL < 40 copies/ml and COVID-19 severity |
| Inciarte et al.[28], n = 53 | No associations between ART regimen and COVID-19 severity | No association between latest CD4+ cell count and COVID-19 severity |
| Huang et al.[30], n = 35 | N/A | Older age and ART discontinuation associated with COVID-19 infection. No association between latest CD4+ cell count or VL and COVID-19 infection |
| Geretti et al.[21], n = 115 | N/A | Age, obesity and diabetes were associated with COVID-19 death among PLWH. No data on CD4+ cell counts or viral loads. 25/30 PLWH who died (80.7%) had an ART record, compared with 87/92 (94.6%) of those who survived (P = 0.07) |
| Sigel et al.[15], n = 88 | PLWH who survived were more likely to have been treated with NRTIs than those PLWH who died (99 vs. 89%, P = 0.04) in univariate analysis. No difference in outcomes for other classes of ART | No association between co-morbidities, latest CD4+ cell count or VL and COVID-19 death |
| Vizcarra et al.[16], n = 51 | Increased TAF use in PLWH with COVID-19 (37/51, 73%), vs. PLWH without COVID-19 (38%, P = 0.0036) | PLWH with COVID-19 were significantly more likely to have co-morbidities (63 vs. 38%, P = 0.00059), and had higher median BMI (25.5 vs. 23.7 kg/m2, P = 0.021) compared with 1288 PLWH without COVID-19. No association between CD4+ T cell count and SARS-CoV-2 infection or adverse COVID-19 outcomes |
| Shalev et al.[17], n = 31 | 7/8 (88%) PLWH who died from COVID-19 used TAF/TDF vs. 10/23 (43%) of those who survived | N/A |
| Karmen-Tuohy et al.[18], n = 21 | N/A | No association between most recent CD4+ cell count and mortality (OR 0.996, 95% CI: 0.992–1.11) |
| Childs et al.[19], n = 18 | More common use of protease inhibitor–containing ART regimens among PLWH with COVID-19 (OR, 2.43, 95% CI, 0.94–6.29) | PLWH hospitalized with COVID-19 were more likely to be of black ethnicity (OR: 12.22, 95% CI: 1.62–92.00), and had lower median CD4+ cell counts (395 vs. 573, P = 0.03) |
3TC, lamivudine; ABC, abacavir; aHR, adjusted hazard ratio; ART, antiretroviral therapy; CI, confidence interval; COVID-19, coronavirus disease 2019; FTC, emtricitabine; NRTIs, nucleotide reverse transcriptase inhibitors; OR, odds ratio; PLWH, people living with HIV; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; TAF, tenofovir alafenamide; TDF, tenofovir disoproxil fumarate; VL, viral load.