This review examines the intersection of the HIV and SARS-CoV-2 pandemics.People with HIV(PWH)are a heterogeneous group that differ in their degree of immune suppression,immune reconstitution,and viral control.While C...This review examines the intersection of the HIV and SARS-CoV-2 pandemics.People with HIV(PWH)are a heterogeneous group that differ in their degree of immune suppression,immune reconstitution,and viral control.While COVID-19 in those with wellcontrolled HIV infection poses no greater risk than that for HIV-uninfected individuals,people with advanced HIV disease are more vulnerable to poor COVID-19 outcomes.COVID-19 vaccines are effective and well tolerated in the majority of PWH,though reduced vaccine efficacy,breakthrough infections and faster waning of vaccine effectiveness have been demonstrated in PWH.This is likely a result of suboptimal humoral and cellular immune responses after vaccination.People with advanced HIV may also experience prolonged infection that may give rise to new epidemiologically significant variants,but initiation or resumption of antiretroviral therapy(ART)can effectively clear persistent infection.COVID-19 vaccine guidelines reflect these increased risks and recommend prioritization for vaccination and additional booster doses for PWH who are moderately to severely immunocompromised.We recommend continued research and monitoring of PWH with SARS-CoV-2 infection,especially in areas with a high HIV burden.展开更多
基金supported by funding from the Wellcome Trust(226137/Z/22/Z)the EDCTP2 program of the European Union’s Horizon 2020 program,TMA2017SF1951-TB-SPEC(to CR)and TMA2016SF-1535-CaTCH-22(to WAB)as well as the Fogarty International Center of the National Institutes of Health and the Eunice Kennedy Shriver National Institute of Child Health&Human Development under Award Number D43 TW010559(to MAH).
文摘This review examines the intersection of the HIV and SARS-CoV-2 pandemics.People with HIV(PWH)are a heterogeneous group that differ in their degree of immune suppression,immune reconstitution,and viral control.While COVID-19 in those with wellcontrolled HIV infection poses no greater risk than that for HIV-uninfected individuals,people with advanced HIV disease are more vulnerable to poor COVID-19 outcomes.COVID-19 vaccines are effective and well tolerated in the majority of PWH,though reduced vaccine efficacy,breakthrough infections and faster waning of vaccine effectiveness have been demonstrated in PWH.This is likely a result of suboptimal humoral and cellular immune responses after vaccination.People with advanced HIV may also experience prolonged infection that may give rise to new epidemiologically significant variants,but initiation or resumption of antiretroviral therapy(ART)can effectively clear persistent infection.COVID-19 vaccine guidelines reflect these increased risks and recommend prioritization for vaccination and additional booster doses for PWH who are moderately to severely immunocompromised.We recommend continued research and monitoring of PWH with SARS-CoV-2 infection,especially in areas with a high HIV burden.
