A new systematic review published in eClinicalMedicine reveals a significant prevalence of long COVID among people living with HIV, highlighting an emerging health concern for this vulnerable population.
The comprehensive analysis, which synthesized data from eight international studies spanning Europe, North America, Africa, and Asia, found that approximately 43% of adults living with HIV developed long COVID symptoms, defined as persistent symptoms 12 weeks after initial COVID-19 infection.
High Prevalence Across Different Analyses
The research team conducted multiple analyses to verify their findings. When focusing solely on studies using the WHO-defined 12-week cutoff for long COVID, the prevalence remained notably consistent at 42% (95% CI, 27% to 58%). This consistency strengthens the reliability of the findings, despite the high heterogeneity observed in the data.
Association Between HIV and Long COVID
While initial unadjusted analyses showed inconclusive results regarding the association between HIV and long COVID (OR 1.16; 95% CI, 0.58-2.29), the relationship became more apparent after adjusting for confounding factors. The adjusted analysis revealed that adults with HIV had more than twice the odds of developing long COVID compared to those without HIV (OR 2.21; 95% CI, 1.12-4.36).
Study Population Characteristics
The review included a median of 267 participants per study, with a median age of 50 years. Women represented approximately 35% of the total study population. Most participants were virally suppressed and had CD4 counts above healthy thresholds, indicating well-managed HIV status.
Clinical Implications and Limitations
The findings raise important considerations for healthcare providers managing patients with HIV during the ongoing COVID-19 pandemic. However, the researchers note several limitations that warrant careful interpretation of the results. The study population primarily consisted of individuals with well-controlled HIV, potentially limiting generalizability to those with more advanced disease or poor viral control.
Research Gaps and Future Directions
The study underscores significant knowledge gaps, particularly regarding the impact of long COVID on HIV patients with lower CD4 counts and those not in regular care. Additionally, the researchers highlight the need for clearer definitions and more comprehensive data collection regarding sex and gender differences in long COVID manifestation among HIV patients.
The findings emphasize the importance of enhanced monitoring and support for people living with HIV who contract COVID-19, given their potentially elevated risk for developing long-term complications.
