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COVID-19 mortality among people with diagnosed HIV compared to those without during the first wave of the COVID-19 pandemic in England

Research output: Contribution to journalArticlepeer-review

Alison E Brown, Sara E Croxford, Sophie Nash, Jameel Khawam, Peter Kirwan, Meaghan Kall, Daniel Bradshaw, Caroline Sabin, Robert F Miller, Frank A Post, Richard Harding, Simon Collins, Laura Waters, David Asboe, David R Chadwick, Valerie Delpech, Ann K Sullivan

Original languageEnglish
Pages (from-to)90-102
Number of pages13
JournalHIV MEDICINE
Volume23
Issue number1
Early online date15 Sep 2021
DOIs
E-pub ahead of print15 Sep 2021
PublishedJan 2022

Bibliographical note

Funding Information: We gratefully acknowledge the continuing collaboration of people living with HIV, as well as clinicians, microbiologists, immunologists, public health practitioners, occupational health doctors, nurses and other colleagues who contribute to the surveillance of HIV in the UK. We also acknowledge the hard work of the PHE COVID-19 Epidemiology Cell in pulling together the death data. Funding Information: SEC, AEB, SN, MK, AKS, PK, JK, VD and SC have no conflicts of interest to declare. DB reports grants from ViiV Healthcare and Gilead Sciences outside the submitted work. LW reports speaker/advisory fees from Gilead Sciences, Viiv Healthcare, Merck Sharp & Dohme (MSD), Janssen‐Cilag, Cipla, Mylan and Theratechnologies and funding for clinical trials from Gilead Sciences and Janssen‐Cilag outside the submitted work. FAP reports grants and personal fees from Gilead Sciences, Viiv Healthcare, Janssen‐Cilag and MSD outside the submitted work. RFM reports personal fees from Gilead Sciences for conference attendance and non‐promotional talks outside the submitted work. CS reports funding from Gilead Sciences and Janssen‐Cilag for participation in advisory panels and for the preparation of educational materials outside the submitted work. DRC reports funding from Gilead Sciences and ViiV Healthcare for the preparation of educational materials and research grants outside the submitted work. RH reports educational consultancies from Gilead Sciences and ViiV Healthcare outside the submitted work. DA reports advisory fees from Gilead Sciences and Viiv Healthcare outside the submitted work. Publisher Copyright: © 2021 Crown copyright. HIV Medicine © 2021 British HIV Association. This article is published with the permission of the Controller of HMSO and the Queen's Printer for Scotland

King's Authors

Abstract

OBJECTIVES: We describe COVID-19 mortality among people with and without HIV during the first wave of the pandemic in England.

METHODS: National surveillance data on adults (aged ≥ 15 years) with diagnosed HIV resident in England were linked to national COVID-19 mortality surveillance data (2 March 2020-16 June 2020); HIV clinicians verified linked cases and provided information on the circumstances of death. We present COVID-19 mortality rates by HIV status, using negative binomial regression to assess the association between HIV and mortality, adjusting for gender, age and ethnicity.

RESULTS: Overall, 99 people with HIV, including 61 of black ethnicity, died of/with COVID-19 (107/100 000) compared with 49 483 people without HIV (109/100 000). Compared to people without HIV, higher COVID-19 mortality rates were observed in people with HIV of black (188 vs. 122/100 000) and Asian (131 vs. 77.0/100 000) ethnicity, and in both younger (15-59 years: 58.3 vs. 10.2/100 000) and older (≥ 60 years: 434 vs. 355/100 000) people. After adjustment for demographic factors, people with HIV had a higher COVID-19 mortality risk than those without (2.18; 95% CI: 1.76-2.70). Most people with HIV who died of/with COVID-19 had suppressed HIV viraemia (91%) and at least one comorbidity reported to be associated with poor COVID-19 outcomes (87%).

CONCLUSIONS: In the first wave of the pandemic in England, COVID-19 mortality among people with HIV was low, but was higher than in those without HIV, after controlling for demographic factors. This supports the strategy of prioritizing COVID-19 vaccination for people with HIV and strongly encouraging its uptake, especially in those of black and Asian ethnicity.

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