Clinical epidemiology of COVID‐19 in people of black ethnicity living with HIV in the UK

Abstract

AbstractObjectivesTo describe the clinical epidemiology of COVID‐19 in people of black ethnicity living with HIV in the UK.MethodsWe investigated the incidence and factors associated with COVID‐19 in a previously established and well‐characterized cohort of black people with HIV. Primary outcomes were COVID‐19 acquisition and severe COVID‐19 disease (requiring hospitalization and/or resulting in death). Cumulative incidence was analysed using Nelson–Aalen methods, and associations between demographic, pre‐pandemic immune‐virological parameters, comorbidity status and (severe) COVID‐19 were identified using Cox regression analysis.ResultsCOVID‐19 status was available for 1847 (74%) of 2495 COVID‐AFRICA participants (median age 49.6 years; 56% female; median CD4 cell count = 555 cells/μL; 93% HIV RNA <200 copies/mL), 573 (31%) of whom reported at least one episode of COVID‐19. The cumulative incidence rates of COVID‐19 and severe COVID‐19 were 31.0% and 3.4%, respectively. Region of ancestry (East/Southern/Central vs. West Africa), nadir CD4 count and kidney disease were associated with COVID‐19 acquisition. Diabetes mellitus [adjusted hazard ratio (aHR) = 2.39, 95% confidence interval (CI): 1.26–4.53] and kidney disease (aHR = 2.53, 95% CI: 1.26–4.53) were associated with an increased risk, and recent CD4 count >500 cells/μL (aHR = 0.49, 95% CI: 0.25–0.93) with a lower risk of severe COVID‐19.ConclusionsRegion of ancestry was associated with COVID‐19 acquisition, and immune and comorbidity statuses were associated with COVID‐19 disease severity in people of black ethnicity living with HIV in the UK.