Guilin Li1,2, Lesley S Park3, Sara Lodi1,4, Roger W Logan1,2, Emily J Cartwright5,6, Lydia Aoun-Barakat7, Juan P Casas8,9,10, Barbra A Dickerman1,2, Christopher T Rentsch11,12,13, Amy C Justice12,14,15, Miguel A Hernán1,2,16. 1. CAUSALab. 2. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. 3. Stanford Center for Population Health Sciences, Stanford University School of Medicine, Palo Alto, California. 4. Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts. 5. Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta. 6. Atlanta VA Medical Center, North Druid Hills, Georgia. 7. Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut. 8. Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System. 9. Department of Medicine, Division of Aging, Brigham & Women's Hospital. 10. Department of Medicine, Harvard Medical School, Boston, Massachusetts. 11. Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut. 12. VA Connecticut Healthcare System, US Department of Veterans Affairs, Washington, DC, USA. 13. Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK. 14. Department of Medicine, Yale School of Medicine. 15. Division of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut. 16. Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Abstract
OBJECTIVE: To compare the risk of coronavirus disease 2019 (COVID-19) outcomes by antiretroviral therapy (ART) regimens among men with HIV. DESIGN: We included men with HIV on ART in the Veterans Aging Cohort Study who, between February 2020 and October 2021, were 18 years or older and had adequate virological control, CD4 + cell count, and HIV viral load measured in the previous 12 months, and no previous COVID-19 diagnosis or vaccination. METHODS: We compared the adjusted risks of documented severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, COVID-19-related hospitalization, and intensive care unit (ICU) admission by baseline ART regimen: tenofovir alafenamide (TAF)/emtricitabine (FTC), tenofovir disoproxil fumarate (TDF)/FTC, abacavir (ABC)/lamivudine (3TC), and other. We fit pooled logistic regressions to estimate the 18-month risks standardized by demographic and clinical factors. RESULTS: Among 20 494 eligible individuals, the baseline characteristics were similar across regimens, except that TDF/FTC and TAF/FTC had lower prevalences of chronic kidney disease and estimated glomerular filtration rate <60 ml/min. Compared with TAF/FTC, the estimated 18-month risk ratio (95% confidence interval) of documented SARS-CoV-2 infection was 0.65 (0.43, 0.89) for TDF/FTC, 1.00 (0.85, 1.18) for ABC/3TC, and 0.87 (0.70, 1.04) for others. The corresponding risk ratios for COVID-19 hospitalization were 0.43 (0.07, 0.87), 1.09 (0.79, 1.48), and 1.21 (0.88, 1.62). The risk of COVID-19 ICU admission was lowest for TDF/FTC, but the estimates were imprecise. CONCLUSION: Our study suggests that, in men living with HIV, TDF/FTC may protect against COVID-19-related events. Randomized trials are needed to investigate the effectiveness of TDF as prophylaxis for, and early treatment of, COVID-19 in the general population.
OBJECTIVE: To compare the risk of coronavirus disease 2019 (COVID-19) outcomes by antiretroviral therapy (ART) regimens among men with HIV. DESIGN: We included men with HIV on ART in the Veterans Aging Cohort Study who, between February 2020 and October 2021, were 18 years or older and had adequate virological control, CD4 + cell count, and HIV viral load measured in the previous 12 months, and no previous COVID-19 diagnosis or vaccination. METHODS: We compared the adjusted risks of documented severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, COVID-19-related hospitalization, and intensive care unit (ICU) admission by baseline ART regimen: tenofovir alafenamide (TAF)/emtricitabine (FTC), tenofovir disoproxil fumarate (TDF)/FTC, abacavir (ABC)/lamivudine (3TC), and other. We fit pooled logistic regressions to estimate the 18-month risks standardized by demographic and clinical factors. RESULTS: Among 20 494 eligible individuals, the baseline characteristics were similar across regimens, except that TDF/FTC and TAF/FTC had lower prevalences of chronic kidney disease and estimated glomerular filtration rate <60 ml/min. Compared with TAF/FTC, the estimated 18-month risk ratio (95% confidence interval) of documented SARS-CoV-2 infection was 0.65 (0.43, 0.89) for TDF/FTC, 1.00 (0.85, 1.18) for ABC/3TC, and 0.87 (0.70, 1.04) for others. The corresponding risk ratios for COVID-19 hospitalization were 0.43 (0.07, 0.87), 1.09 (0.79, 1.48), and 1.21 (0.88, 1.62). The risk of COVID-19 ICU admission was lowest for TDF/FTC, but the estimates were imprecise. CONCLUSION: Our study suggests that, in men living with HIV, TDF/FTC may protect against COVID-19-related events. Randomized trials are needed to investigate the effectiveness of TDF as prophylaxis for, and early treatment of, COVID-19 in the general population.
Authors: Lisa A Eaton; Derrick D Matthews; Leigh A Bukowski; M Ruvel Friedman; Cristian J Chandler; Darren L Whitfield; Jordan M Sang; Ron D Stall Journal: J Acquir Immune Defic Syndr Date: 2018-11-01 Impact factor: 3.731
Authors: Julia Del Amo; Rosa Polo; Santiago Moreno; Asunción Díaz; Esteban Martínez; José Ramón Arribas; Inma Jarrín; Miguel A Hernán Journal: Epidemiology Date: 2020-11 Impact factor: 4.822
Authors: Michael W Traeger; Sophia E Schroeder; Edwina J Wright; Margaret E Hellard; Vincent J Cornelisse; Joseph S Doyle; Mark A Stoové Journal: Clin Infect Dis Date: 2018-08-16 Impact factor: 9.079
Authors: Amy C Justice; Elizabeth Dombrowski; Joseph Conigliaro; Shawn L Fultz; Deborah Gibson; Tamra Madenwald; Joseph Goulet; Michael Simberkoff; Adeel A Butt; David Rimland; Maria C Rodriguez-Barradas; Cynthia L Gibert; Kris Ann K Oursler; Sheldon Brown; David A Leaf; Matthew B Goetz; Kendall Bryant Journal: Med Care Date: 2006-08 Impact factor: 2.983
Authors: Anthony T Podany; Sara H Bares; Joshua Havens; Shetty Ravi Dyavar; Jennifer O'Neill; Sarah Lee; Courtney V Fletcher; Susan Swindells; Kimberly K Scarsi Journal: AIDS Date: 2018-03-27 Impact factor: 4.177
Authors: Oche O Agbaji; Isaac O Abah; Augustine O Ebonyi; Zumnan M Gimba; Esla E Abene; Simji S Gomerep; Kakjing D Falang; Joseph Anejo-Okopi; Patricia A Agaba; Placid O Ugoagwu; Emmanuel I Agaba; Godwin E Imade; Atiene S Sagay; Prosper Okonkwo; John A Idoko; Phyllis J Kanki Journal: J Int Assoc Provid AIDS Care Date: 2019 Jan-Dec
Authors: Sonia Hernandez-Diaz; Brian T Bateman; Loreen Straub; Yanmin Zhu; Helen Mogun; Michael Fischer; Krista F Huybrechts Journal: Am J Epidemiol Date: 2021-04-13 Impact factor: 4.897
Authors: Oskar Ayerdi; Teresa Puerta; Petunia Clavo; Mar Vera; Juan Ballesteros; Manuel Enrique Fuentes; Vicente Estrada; Carmen Rodríguez; Jorge Del Romero Journal: Open Forum Infect Dis Date: 2020-09-25 Impact factor: 3.835