People with HIV at higher risk of COVID reinfection, CDC study finds

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Thursday, October 19, 2023
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People with HIV are at increased risk of being reinfected with the virus that causes COVID-19, according to new federal data.

Researchers from the Centers for Disease Control and Prevention and the Chicago Department of Public Health followed adult residents in Chicago from their first reported infection from March 2020 through the end of May 2022, according to the report published Wednesday by the CDC.

The team compared COVID test laboratory data and COVID vaccine administration data to Chicago's Enhanced HIV/AIDS Reporting System.

About 5% experienced reinfection among more than 453,000 Chicago residents who tested positive for the virus.

Rates of reinfection were higher among people with HIV (6.7%) than among people without HIV (5.2%).

People with HIV are more likely to have completed a primary COVID vaccine series plus a booster before their reinfection -- 31.8% versus 27% for those without HIV.

Reinfection rates were consistently higher throughout the pandemic for people with HIV and were highest during the original omicron variant phase, according to the report.

"Understanding if persons with HIV have a higher risk for SARS-CoV-2 reinfection may help tailor future COVID-19 public health guidance," the authors wrote. "[Persons with HIV] should follow the recommended COVID-19 vaccine schedule, including booster doses, to avoid SARS-CoV-2 reinfections."

Those who were reinfected were more likely to be male, older and Black or African American compared to those without HIV, the study found.

People with HIV were also less likely to have been unvaccinated at the time of their first infection compared to people without HIV.

The report notes the findings are a reminder about the risks of reinfection for those who are immunocompromised.

HIV can weaken the immune system, infecting and destroying CD4 cells, which causes the white blood cell count to drop and compromises the immune system.

This means that people with HIV are susceptible to COVID infection especially those who are not on antiretroviral therapy (ART).

ART is a combination of drugs that suppresses a person's viral load until HIV Is virtually undetectable. The ability of ART to control viral replication has been shown to greatly improve immune system function, studies show.

"Evaluating the association between HIV infection and SARS-CoV-2 reinfections using surveillance data can help strengthen public health recommendations including the need for extra doses as part of a primary series, booster doses of vaccine, and optimized ART in [persons with HIV]," the authors wrote. "Tailored guidance and prevention messaging for [persons with HIV] can help reduce the elevated risk we identified in this analysis and limit continued SARS-CoV-2 transmission."

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