COVID-19 infections post-vaccination by HIV status in the United States.
| العنوان: | COVID-19 infections post-vaccination by HIV status in the United States. |
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| المؤلفون: | Coburn SB; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA., Humes E; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA., Lang R; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.; Department of Medicine, University of Calgary, Calgary, Canada., Stewart C; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA., Hogan BC; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA., Gebo KA; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA., Napravnik S; Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.; Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Edwards JK; Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Browne LE; Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Park LS; Stanford Center for Population Health Sciences, Palo Alto, CA, USA., Justice AC; Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA.; Department of Medicine, Yale School of Medicine, New Haven, CT, USA.; VA Connecticut Healthcare System, West Haven, CT, USA., Gordon K; Department of Medicine, Yale School of Medicine, New Haven, CT, USA.; VA Connecticut Healthcare System, West Haven, CT, USA., Horberg MA; Kaiser Permanente Mid-Atlantic Permanente Research Institute, Rockville, MD, USA., Certa JM; Kaiser Permanente Mid-Atlantic Permanente Research Institute, Rockville, MD, USA., Watson E; Kaiser Permanente Mid-Atlantic Permanente Research Institute, Rockville, MD, USA., Jefferson CR; Kaiser Permanente Mid-Atlantic Permanente Research Institute, Rockville, MD, USA., Silverberg M; Kaiser Permanente Northern California, Division of Research, Oakland CA, USA., Skarbinski J; Kaiser Permanente Northern California, Division of Research, Oakland CA, USA.; Department of Infectious Diseases, Oakland Medical Center, Oakland CA, USA., Leyden WA; Kaiser Permanente Northern California, Division of Research, Oakland CA, USA., Williams CF; Epidemiology Branch, Division of AIDS at National Institute of Allergy and Infectious Diseases (NIAID), National Institute of Health (NIH), Rockville, MD, USA., Althoff KN; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. |
| مؤلفون مشاركون: | Corona-Infectious-Virus Epidemiology Team (CIVETs) of the NA-ACCORD of IeDEA |
| المصدر: | MedRxiv : the preprint server for health sciences [medRxiv] 2021 Dec 05. Date of Electronic Publication: 2021 Dec 05. |
| نوع المنشور: | Preprint |
| اللغة: | English |
| بيانات الدورية: | Country of Publication: United States NLM ID: 101767986 Publication Model: Electronic Cited Medium: Internet NLM ISO Abbreviation: medRxiv Subsets: PubMed not MEDLINE |
| مستخلص: | Importance: Recommendations for additional doses of COVID vaccine are restricted to people with HIV who have advanced disease or unsuppressed HIV viral load. Understanding SARS-CoV-2 infection risk post-vaccination among PWH is essential for informing vaccination guidelines. Objective: Estimate the risk of breakthrough infections among fully vaccinated people with (PWH) and without (PWoH) HIV in the US. Design Setting and Participants: The Corona-Infectious-Virus Epidemiology Team (CIVET)-II cohort collaboration consists of 4 longitudinal cohorts from integrated health systems and academic health centers. Each cohort identified individuals ≥18 years old, in-care, and fully vaccinated for COVID-19 through 30 June 2021. PWH were matched to PWoH on date fully vaccinated, age group, race/ethnicity, and sex at birth. Incidence rates per 1,000 person-years and cumulative incidence of breakthrough infections with 95% confidence intervals ([,]) were estimated by HIV status. Cox proportional hazards models estimated adjusted hazard ratios (aHR) of breakthrough infections by HIV status adjusting for demographic factors, prior COVID-19 illness, vaccine type (BNT162b2, [Pfizer], mRNA-1273 [Moderna], Jansen Ad26.COV2.S [J&J]), calendar time, and cohort. Risk factors for breakthroughs among PWH, were also investigated. Exposure: HIV infection. Outcome: COVID-19 breakthrough infections, defined as laboratory evidence of SARS-CoV-2 infection or COVID-19 diagnosis after an individual was fully vaccinated. Results: Among 109,599 individuals (31,840 PWH and 77,759 PWoH), the rate of breakthrough infections was higher in PWH versus PWoH: 44 [41, 48] vs. 31 [29, 33] per 1,000 person-years. Cumulative incidence at 210 days after date fully vaccinated was low, albeit higher in PWH versus PWoH overall (2.8% versus 2.1%, log-rank p<0.001, risk difference=0.7% [0.4%, 1.0%]) and within each vaccine type. Breakthrough infection risk was 41% higher in PWH versus PWoH (aHR=1.41 [1.28, 1.56]). Among PWH, younger age (18-24 versus 45-54), history of COVID-19 prior to fully vaccinated date, and J&J vaccination (versus Pfizer) were associated with increased risk of breakthroughs. There was no association of breakthrough with HIV viral load suppression or CD4 count among PWH. Conclusions and Relevance: COVID-19 vaccination is effective against infection with SARS-CoV-2 strains circulating through 30 Sept 2021. PWH have an increased risk of breakthrough infections compared to PWoH. Recommendations for additional vaccine doses should be expanded to all PWH. |
| التعليقات: | Update in: JAMA Netw Open. 2022 Jun 1;5(6):e2215934. (PMID: 35671054) |
| References: | PLoS One. 2020 Dec 7;15(12):e0243523. (PMID: 33284865) N Engl J Med. 2021 Jun 10;384(23):2187-2201. (PMID: 33882225) MMWR Morb Mortal Wkly Rep. 2021 May 28;70(21):792-793. (PMID: 34043615) Int J Epidemiol. 2007 Apr;36(2):294-301. (PMID: 17213214) Med Care. 2006 Aug;44(8 Suppl 2):S25-30. (PMID: 16849965) J Infect. 2021 Aug;83(2):237-279. (PMID: 34052241) J Clin Virol. 2020 Sep;130:104577. (PMID: 32777762) Annu Rev Med. 2011;62:141-55. (PMID: 21090961) Am J Transplant. 2021 Jun;21(6):2290-2297. (PMID: 34085760) N Engl J Med. 2020 Dec 31;383(27):2603-2615. (PMID: 33301246) JAMA Netw Open. 2021 Feb 1;4(2):e2037069. (PMID: 33533933) MMWR Morb Mortal Wkly Rep. 2021 Apr 02;70(13):495-500. (PMID: 33793460) N Engl J Med. 2021 Jun 10;384(23):2212-2218. (PMID: 33882219) EClinicalMedicine. 2021 Aug 28;40:101117. (PMID: 34476395) J Med Virol. 2021 Jan;93(1):506-512. (PMID: 32644223) J Aging Health. 2021 Aug-Sep;33(7-8):577-584. (PMID: 33779385) Lancet HIV. 2021 Nov;8(11):e690-e700. (PMID: 34655550) World Psychiatry. 2021 Oct 5;:. (PMID: 34612005) N Engl J Med. 2021 Feb 4;384(5):403-416. (PMID: 33378609) Clin Case Rep. 2021 Jan 13;9(3):1397-1401. (PMID: 33768853) JAMA. 2021 Jun 22;325(24):2500-2502. (PMID: 33956050) Science. 2021 Nov 4;:eabm0620. (PMID: 34735261) Transplantation. 2021 Oct 1;105(10):e139-e141. (PMID: 34319928) Am J Transplant. 2021 Aug;21(8):2916-2918. (PMID: 34101990) |
| معلومات مُعتمدة: | R01 DA011602 United States DA NIDA NIH HHS; K23 EY013707 United States EY NEI NIH HHS; U54 GM133807 United States GM NIGMS NIH HHS; U01 AI038855 United States AI NIAID NIH HHS; U01 HL146208 United States HL NHLBI NIH HHS; UL1 RR024131 United States RR NCRR NIH HHS; U01 HL146192 United States HL NHLBI NIH HHS; U01 AI069432 United States AI NIAID NIH HHS; U01 HL146201 United States HL NHLBI NIH HHS; U01 AA020790 United States AA NIAAA NIH HHS; KL2 TR000421 United States TR NCATS NIH HHS; K01 AI131895 United States AI NIAID NIH HHS; F31 DA037788 United States DA NIDA NIH HHS; U01 HL146241 United States HL NHLBI NIH HHS; R01 AA016893 United States AA NIAAA NIH HHS; N01 CP001004 United States CP NCI NIH HHS; P30 AI027767 United States AI NIAID NIH HHS; U01 DA036297 United States DA NIDA NIH HHS; P30 AI050409 United States AI NIAID NIH HHS; U01 HL146333 United States HL NHLBI NIH HHS; F31 AI124794 United States AI NIAID NIH HHS; P30 MH062246 United States MH NIMH NIH HHS; U01 AI069434 United States AI NIAID NIH HHS; P30 AI094189 United States AI NIAID NIH HHS; U01 HL146245 United States HL NHLBI NIH HHS; UL1 TR001863 United States TR NCATS NIH HHS; G12 MD007583 United States MD NIMHD NIH HHS; K24 DA000432 United States DA NIDA NIH HHS; U01 HL146205 United States HL NHLBI NIH HHS; U01 DA036935 United States DA NIDA NIH HHS; R24 AI067039 United States AI NIAID NIH HHS; U01 HL146242 United States HL NHLBI NIH HHS; N02CP55504 United States CP NCI NIH HHS; U01 AI038858 United States AI NIAID NIH HHS; U10 EY008057 United States EY NEI NIH HHS; U01 AI068636 United States AI NIAID NIH HHS; U01 HL146193 United States HL NHLBI NIH HHS; U10 EY008052 United States EY NEI NIH HHS; UL1 TR002378 United States TR NCATS NIH HHS; P30 AI110527 United States AI NIAID NIH HHS; R34 DA045592 United States DA NIDA NIH HHS; P30 AI027763 United States AI NIAID NIH HHS; K01 AI093197 United States AI NIAID NIH HHS; U01 AI069918 United States AI NIAID NIH HHS; K24 AI118591 United States AI NIAID NIH HHS; K24 AI065298 United States AI NIAID NIH HHS; U01 AA013566 United States AA NIAAA NIH HHS; UL1 TR000083 United States TR NCATS NIH HHS; P30 AI027757 United States AI NIAID NIH HHS; U01 HL146204 United States HL NHLBI NIH HHS; R01 DA012568 United States DA NIDA NIH HHS; U01 HL146202 United States HL NHLBI NIH HHS; UL1 TR000004 United States TR NCATS NIH HHS; U01 HL146240 United States HL NHLBI NIH HHS; R01 AG053100 United States AG NIA NIH HHS; U10 EY008067 United States EY NEI NIH HHS; P30 AI036219 United States AI NIAID NIH HHS; Z01 CP010176 United States ImNIH Intramural NIH HHS; U01 HL146194 United States HL NHLBI NIH HHS; U24 AA020794 United States AA NIAAA NIH HHS; U01 HL146203 United States HL NHLBI NIH HHS; U01 AI068634 United States AI NIAID NIH HHS; P30 AI050410 United States AI NIAID NIH HHS |
| تواريخ الأحداث: | Date Created: 20211215 Latest Revision: 20240214 |
| رمز التحديث: | 20240214 |
| مُعرف محوري في PubMed: | PMC8669858 |
| DOI: | 10.1101/2021.12.02.21267182 |
| PMID: | 34909791 |
| قاعدة البيانات: | MEDLINE |
| DOI: | 10.1101/2021.12.02.21267182 |
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