Institute for Global Health


Association of HIV with outcomes of COVID-19 hospitalization outcomes

Outcomes of COVID-19-related hospitalization among people with HIV in the ISARIC World Health Organization (WHO) Clinical Characterization Protocol (UK)

Project Summary

Untreated HIV results in immune dysfunction leaving people living with HIV at greater risk of some infections. For people with HIV, effective treatment with antiretroviral therapy (ART) suppresses viral replication allowing the immune system to recover.

Treatment means that most people with HIV who are stable on treatment are not considered to be immunocompromised.  However, people with HIV are still more likely to get some infections, despite effective HIV treatment.

Furthermore, as the population of people with HIV has aged, the prevalence of many age-related comorbidities has increased, with this group now being at higher risk of several comorbidities.  The potential impact of HIV on the outcome of COVID-19 infections is therefore unknown.

To characterize the presenting characteristics and outcomes of COVID-19 related hospitalization in people with HIV relative to those without HIV in the UK, we analyzed data collected within the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) World Health Organization (WHO) Clinical Characterization Protocol (CCP), the largest prospective observational study of patients admitted to hospital with COVID-19 worldwide.

Among 47 592 patients, 122 (0.26%) had confirmed HIV infection; this group were were younger at presentation and had fewer comorbidities, more systemic symptoms and higher lymphocyte counts and C-reactive protein levels.

Although the cumulative day-28 mortality was similar in the HIV-positive versus HIV-negative groups (26.7% vs. 32.1%; P = .16), after adjusting for age, mortality was higher in those with HIV (adjusted hazard ratio 1.47, 95% confidence interval 1.01–2.14; P=0.05). 

Findings from the study were published as evidence by SAGE with both Professor Sir Patrick Vallance and Professor Sir Chris Whitty commenting on the importance of the findings.  

This project is being run by the NIHR Health Protection Research Unit (HPRU) in Blood-Borne and Sexually Transmitted Infections at UCL.