This is a summary, written by members of the CITF Secretariat, of:

Puyat JH, Fowokan A, Wilton J, Janjua NZ, Wong J, Grennan T, Chambers C, Kroch A, Costiniuk CT, Cooper CL, Lauscher D, Strong M, Burchell AN, Anis A, Samji H. Risk of COVID-19 Hospitalization in People Living with HIV and HIV-Negative Individuals and the Role of COVID-19 Vaccination: A Retrospective Cohort Study. Int J Infect Dis. 2023 Jul 5:S1201-9712(23)00650-1. doi: 10.1016/j.ijid.2023.06.026.

The results and/or conclusions contained in the research do not necessarily reflect the views of all CITF members.

A CITF-funded study, published in the International Journal of Infectious Diseases, found that people living with HIV (PLWH) had more than two times the risk of being hospitalized with COVID-19 as did HIV-negative individuals. The difference in risk can be explained by sociodemographic factors and a history of comorbidity. The findings underscore the need to address the social and comorbid vulnerabilities (e.g., injecting drugs) that were more prominent among PLWH. The study was led by Dr. Aslam Anis (University of British Columbia) in collaboration with Dr. Hasina Samji (Simon Fraser University).

Key findings:

  • A higher proportion of PLWH were hospitalized within 14 days of COVID-19 diagnosis (17.5%) than HIV-negative people (7.6%) in this population-based retrospective cohort study. The proportion of people who received critical care during hospitalization was also higher among PLWH (2.6%) than among HIV-negative individuals (1.7%).
  • The risk of hospitalization within 14 days of COVID-19 diagnosis was more than two-fold higher among PLWH than HIV-negative people. The hazard ratio was 2.44 for the overall sample and was nearly the same during the pre-Omicron period from December 15, 2020, to November 21, 2021 (HR – 2.52) and during the Omicron period from November 22, 2021, to October 31, 2022 (HR – 2.46).
  • The PLWH included in the study were predominantly male (66.4%) and had a median age of 50, while HIV-negative individuals included a larger proportion of females (54%) and had a median age of 42. A relatively higher proportion of PLWH resided in the poorest neighborhood income quintile (41.9%) and in the Vancouver Coastal Health region (50.9%), while there was an even distribution of HIV-negative individuals across neighborhood income quintiles and a relatively larger proportion of people living in the Fraser Health region.
  • A substantially larger proportion of PLWH had a history of injecting drugs (42.9% versus 4.3% in HIV-negative people) and had 3 or more comorbid conditions (50.9% versus 28.0% of HIV-negative people).

The study population included all individuals who tested positive for SARS-CoV-2 between December 15, 2020, when COVID-19 vaccination first started in BC and October 31, 2022, when data analysis started. Using linked health data, the study included 658 PLWH and 252,471 HIV-negative individuals, 19 years of age and older. The study excluded people who were under 19 years of age as of December 15, 2020, were not residents of BC, had unknown place of residence, were missing data on income, or had invalid dates of death.

Overall, this study underscores the need for public health programs and interventions to address social and comorbid vulnerabilities—particularly the high rates of injection drug use among PLWH—and the importance of vaccinations in mitigating the morbidity impacts of the COVID-19 pandemic.