Prevalence, clinical characteristics and treatment outcomes of HIV and SARS-CoV-2 co-infection: a systematic review and meta-analysis

ObjectivesTo determine the prevalence, clinical characteristics and outcomes of HIV and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) co-infection. MethodsWe searched Medline, Embase, Cochrane and Web of Science databases and grey literature for studies reporting epidemiological and clinical data of patients with HIV and SARS-CoV-2 co-infection. Eligible studies were all observational or interventional studies and commentaries in English language that reported patient data on HIV/SARS-CoV-2 co-infection. We used random effect meta-analysis to determine the pooled prevalence and mortality. ResultsOf the 17 eligible studies, there were 3 retrospective cohorts, 1 survey, 5 case series, 7 case reports and 1 commentary that reported on a total of 146 HIV infected individuals. The pooled prevalence of HIV among individuals with SARS-CoV-2 infection was 1.0% (95% CI: 0.0 - 3.0, I2 = 79.3%, p = 0.01), whereas the prevalence of SARS-CoV-2 among HIV patients was 0.68% (95% CI: 0.34 - 1.34).There were 110 (83.8%) HIV/ SARS-CoV-2 co-infected males, and the age (range) of the co-infected was 30 - 60 years. A total of 129 (97.0%) were anti-retroviral therapy experienced, and 113 (85.6%) had a suppressed HIV viral load. The CD4 count (range) was 298 - 670 cells/mm3 (n = 107). The commonest symptoms were fever (73.5%, n = 75) and cough (57.8%, n = 59). Sixty-two (65.3%) patients had at least one other comorbid condition, of which hypertension (26.4%, n = 38) was the commonest. Chest radiological imaging abnormalities were found in 46 (54.1%) cases. Twenty-eight cases (56.0%) were reported as mild. Recovery occurred in 120 (88.9%) cases, and the pooled mortality was 9% (95% CI: 3.0 - 15.0, I2 = 25.6%, p = 0.24). ConclusionThe prevalence of HIV/SARS-CoV-2 co-infection was low. The clinical characteristics and outcomes of HIV/SARS-CoV-2 co-infection are comparable to those reported among HIV negative SARS-CoV-2 cases.