COVID-19 presents double the risk of death for people living with HIV

According to data presented at the British HIV Association (BHIVA) and British Association of Sexual Health and HIV (BASHH) joint conference last week, people living with HIV in England had double the risk of dying of COVID-19 compared to the general population.

Dr Sara Croxford, Public Health England (PHE), presented data from a PHE study that found that over two-thirds of COVID-19 deaths in people living with HIV were in Black, Asian or other non-white ethnic groups. Another study found people living with HIV who had a CD4 count below 200 cells had a higher risk of severe disease, as did Black Africans and obese people.

Public Health England drew from anonymised HIV surveillance data for the period 2nd March to 16th June 2020. 99 deaths, attributed to COVID-19, in people living with HIV were identified. For context there are and estimated 96,200 people living with HIV in England, so 99 deaths represents around 0.1% of all people living with HIV in the country.

Dr Croxford compared the death rates from COVID-19 in people living with HIV to the rest of the country’s population.

Black people, over 60, with HIV: 985 per 100,000

Black people, over 60, without HIV: 521 per 100,00

Asian people, over 60, with HIV: 781 per 100,000

Asian people, over 60, without HIV: 460 per 100,00

People in London, over 60, with HIV: 722 per 100,000

People in London, over 60, without HIV: 521 per 100,000

Other findings included:

Women were 45% less likely to die from COVID-19 than men.

Each 5-year increase in age increased risk of COVID-19 related death by 79%

Black people were more than three times (aRR 3.44), Asian people more than twice (aRR 2.24) and other ethnicities more than three times (aRR 3.23) at risk of COVID-19 related death compared to white people.

People living with HIV were around twice as likely (aRR 2.18) to die of COVID-19 than HIV negative people.

Most (87%) of those identified as having died of COVID-19 and HIV had at least one comorbidity that would have increased the risk of severe disease course or death. The study was too small to be able to say whether people living with HIV have more comorbidities or whether this is the reason for increased risk of COVID-19 related death.

BHIVA say that the findings reinforce the importance of advice for prompt vaccination against COVID-19 for people with low CD4 counts and/or recent AIDS-defining illnesses.