Saturday, Mar 6, 2021: 12:01 AM
Lesley S. Park1, Kathleen A. McGinnis2, Kirsha Gordon2, Michael A. Horberg3, Celeena R. Jefferson4, Lisa Bastarache5, Srushti Gangireddy6, Michael J. Silverberg7, Wendy Leyden8, Sonia Napravnik9, Deana Agil9, Alison G. Abraham10, Gypsyamber D'Souza11, Keri N. Althoff11, for the CIVET Collaboration of the NA-ACCORD of IeDEA
1Stanford University, Stanford, CA, USA, 2VA Connecticut Healthcare System, West Haven, CT, USA, 3Kaiser Permanente Mid-Atlantic States, Washington, DC, USA, 4Mid-Atlantic Permanente Research Institute, Rockville, MD, USA, 5Aaron Diamond AIDS Research Center, New York, NY, USA, 6Vanderbilt University Medical Center, Nashville, TN, USA, 7Kaiser Permanente Division of Research, Oakland, CA, USA, 8Kaiser Permanente, Oakland, CA, USA, 9University of North Carolina, Chapel Hill, Chapel Hill, NC, USA, 10University of Colorado Denver, Aurora, CO, USA, 11Johns Hopkins University, Baltimore, MD, USA
It is not known if people with HIV (PWH) in the United States (US) have different access to SARS-CoV-2 RT-PCR (COVID-19) testing, or positivity proportions (among those tested), than people without HIV (PWOH). We describe COVID-19 testing and positivity proportions in 6 large geographically and demographically diverse cohorts of PWH and PWOH.
The Corona-Infectious-Virus Epidemiology Team (CIVET) is comprised of five COVID-19 clinical cohorts within a health system (Kaiser Permanente Northern California, Oakland, CA; Kaiser Permanente Mid-Atlantic States, Rockville, MD; University of North Carolina Health, Chapel Hill, NC; Vanderbilt University Medical Center, Nashville, TN; Veterans Aging Cohort Study) and one established classical HIV cohort (MACS/WIHS Combined Cohort Study). Each participating cohort is restricted to individuals who were alive and "in-cohort" in 2020 (definitions of which were operationalized to fit the structure of each cohort). We calculated the percentage of patients in-cohort who were COVID-19 tested, and the proportion COVID-19 positive monthly, by HIV status, from March 1 to August 31, 2020. We report findings from the classical cohort separately because results are based on self-reported information.
In the 5 clinical cohorts, PWH ranged from N=2,515 to 31,040, and N=77,019 to 3,710,360 PWOH. Over the 6 month study period, the percentage of PWH who were tested for COVID-19 (13.5%-21.2%) was slightly higher than PWOH (10.8%-14.3%) in each of the cohorts (p-values in each cohort <0.001). However, among those tested, the percentage of patients with positive COVID-19 tests was similar regardless of HIV status (Figure). In the classical cohort that contributed self-reported testing and positive information (PWH N=2,222; PWOH N=1,417), the proportion tested was similar by HIV status (PWH 38.1% vs. PWOH 37.4%), but PWH had a greater positivity proportion (9.0%) compared with PWOH (5.3%, p-value=0.012).
Although PWH had higher testing rates compared with PWOH, we did not find evidence of increased positivity among those tested in 5 clinical cohorts with large diverse populations across the US. We will continue to monitor testing, positivity, and COVID-19 related health outcomes in PWH and PWOH using our multiple data sources and leveraging the expertise of established longitudinal cohort studies in the CIVETS collaboration.
(R) Epidemiology of HIV and SARS-CoV-2 in Adults
Does this abstract include any aspects of research on SARS-CoV-2 or COVID-19?
Prior Presentation or Publication: In general, CROI does not accept work that has been previously published or publicly presented. Abstract text that is under copyright by a publication or another conference should not be submitted verbatim to CROI. Consideration may be given to a previously presented submission if meaningful newer data or different analyses are included or if the prior presentation was to a conference not focused on HIV- or SARS-CoV-2-related topics. Have your study data or abstract information been published, submitted for publication where publication is anticipated on or before the start of the CROI where you will present, or presented at any other major national or international scientific or medical HIV-related conferences (ie, generally 400 or more attendees)?