We aimed to assess the SARS-CoV-2 prevalence and factors associated with seropositivity and asymptomatic COVID-19 among PWH.
Cross-sectional study carried out within the cohort of the Spanish HIV Research Network. Participants were consecutive PWH with plasma collected from April 1st to September 30th, 2020. We determined SARS-CoV-2 antibodies (Ab) in plasma. Illness severity (NIH criteria) was assessed by medical records review and, if needed, participant interviews. Multivariable logistic regression analysis was used to identify predictors of seropositivity among the following variables: sex, age, country of birth, education level, comorbidities (hypertension, chronic heart disease, diabetes mellitus, non-AIDS related cancer, chronic kidney disease, cirrhosis), route of HIV acquisition, prior AIDS, CD4+ cell count, HIV viral load, nucleoside/nucleotide reverse transcriptase inhibitor (N[t]RTI) backbone, type of third antiretroviral drug, and month of sample collection.
Of 1,076 PWH (88.0% males, median age 43 yr., 97.7% on antiretroviral therapy, median CD4+ 688 cells/mm3, 91.4% undetectable HIV viral load), SARS-CoV-2 Ab were detected in 91 PWH, for a seroprevalence of 8.5% (95%CI: 6.9% – 10.3%). Forty-five infections (45.0%) were asymptomatic. Variables independently associated with SARS-CoV-2 seropositivity were birth in Latin American Countries vs. Spain (adjusted odds ratio [aOR]: 2.30, 95%CI: 1.41 – 3.76; P=0.001), and therapy with tenofovir disoproxil fumarate plus emtricitabine (TDF/FTC) vs tenofovir alafenamide (TAF)/FTC as the N(t)RTI backbone (aOR: 0.49, 95%CI: 0.26 – 0.94; P=0.031).
Many SARS-CoV-2 infections among PWH were asymptomatic, and birth in Latin American countries increased the risk of SARS-CoV-2 seropositivity. Our analysis, adjusted by comorbidities and other variables, suggests TDF/FTC may prevent SARS-CoV-2 infection among PWH.

Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.