The following is a summary of “Risk of COVID-19 hospitalisation by HIV-status and SARS-CoV-2 vaccination status during pre- and post-Omicron era in a national register-based cohort study in Sweden,” published in the September 2024 issue of Infectious Disease by Möller et al. 

Researchers conducted a retrospective study to analyze the consequences of COVID-19 in people living with HIV (PLHIV) during the Omicron era, focusing on the impact of vaccination status.  

They performed a study of Swedish residents ≥18 years with positive SARS-CoV-2 PCR tests from January 2021 to February 2023 and estimated adjusted odds ratios (adjOR) for COVID-19 hospitalization and severe COVID-19 (ICU admission and 90-day mortality), categorized by SARS-CoV-2 vaccination status (0–1, 2, and ≥3 doses) and HIV status. The outcomes were analyzed during pre-Omicron, Omicron during public testing, and after public testing periods.  

The results showed 1,348 PLHIV and 1,669,389 PWoH were included. PLHIV were older, more migrant (65% vs. 22%), and male (59% vs. 46%). Of PLHIV, 96% were on antiretroviral treatment, and 94% were virally suppressed. COVID-19 hospitalization adjORs were similar regardless of HIV status, controlling for demographics, calendar month of infection, comorbidities, and income. PLHIV were more likely to be hospitalized than PWoH during Omicron and public testing (adjOR 2.3, 95% CI 1.1–4.2) but not after public testing. Severe COVID-19 odds were 3 times higher in PLHIV compared to PWoH vaccinated with 2 doses (adjOR 3.2, 95% CI 1.3–6.9), but not when vaccinated with ≥3 doses (adjOR 0.7, 95% CI 0.2–1.6). Migrant and low nadir CD4 ⁺T-cells were associated with higher odds of hospitalization in PLHIV unvaccinated.  

They concluded that well-treated PLHIV highlights the importance of vaccination with a booster dose for adequate protection against severe COVID-19 in PLHIV. 

Source: tandfonline.com/doi/full/10.1080/23744235.2024.2405582#abstract