1091. HIV Does Not Increase Risk of Disease Severity in Patients with COVID-19 Infection

• Published in: Open forum infectious diseases Vol. 9; no. Supplement_2
• Main Authors: Bangash, Salman, Betancourth, Adriana, Khan, Ayesha, Hsiao, Chiu-Bin, Oehler, Cassandra, Abalos, Charmaine Clarisse D
• Format: Journal Article
• Language: English
• Published: 15.12.2022
• ISSN: 2328-8957; 2328-8957
• DOI: 10.1093/ofid/ofac492.931

Abstract Background Limited literature on the impact of COVID-19 infection in persons living with HIV infection (PLWHIV) has shown conflicting results, especially on the degree of disease severity and morbidity/mortality risk impact. The advent of vaccinations against COVID-19 infection helped combat this horrific pandemic. However, their efficacy in immunocompromised hosts is understudied. The measurement of anti-spike antibody levels makes them an ideal surrogate to study the efficacy of the immune response conferred after vaccination. Methods A quality improvement project was conducted between 03/2020 and 03/2022 at Positive Health Clinic (PHC), a Pittsburgh urban Ryan White-funded HIV clinic, where approximately 930 PLWHIV receive care. PHC patients who tested positive for COVID-19 were followed up for their clinical presentations and outcomes. Goals were to observe longitudinal clinical impact with or without vaccinations; the COVID-19 vaccination acceptance and its serum anti-spike antibody response (AS-Ab); and COVID-19 variants impact on protection by vaccination. Results By 02/21, a 70% vaccination rate was achieved for PHC PLWHIV. 136 serum AS-Ab tests were collected at least 28 days after completing the primary vaccination series. Five non-responders were noted (2 renal transplant recipients, 2 with advanced AIDS with uncontrolled HIV, and 1 with liver cirrhosis). Low AS-Ab titers were observed in patients with CD4 < 200 or HIV VL > 200. A total of 109 COVID-19 infections in 105 patients were seen. From 03/20 – 11/21, there were 53 infections noted (45 unvaccinated: 5 with severe disease; 8 vaccinated: 0 severe disease). 58 infections (8 unvaccinated, 2 severe, 50 vaccinated (including four 2nd infections: 0 severe) were observed during 11/221 – 03/22. No mortality was noted. Figure 1.Figure 2.Figure 3Demographics of PHC Conclusion This report did not show mortality directly associated with COVID-19 infection in PLWHIV. Moreover, COVID-19 vaccination is known to reduce the risk and severity of COVID-19 infection in the general population, which was consistent across our study. Interestingly, there were very few COVID-19 infections diagnosed in PLWHIV who had low CD4 count and uncontrolled HIV (CD4 < 200 & HIV VL > 500 copies) even after the surge of the Omicron variant. Disclosures All Authors: No reported disclosures.