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New center led by Centers for Disease Control and Prevention study COVID-19 reinfection rates were found to be higher among people living with HIV (PWH) than among people without HIV (PWOH).

The study was published yesterday in emerging infectious diseases, involving 453,587 adults in Chicago infected with SARS-CoV-2 between first infection and May 2022. Researchers matched COVID-19 test results and vaccination data with Chicago’s Enhanced HIV/AIDS Reporting System.

“HIV impairs the immune system; people living with HIV (PWH), especially those not receiving antiretroviral therapy (ART), may be vulnerable to SARS-CoV-2 infection,” the researchers wrote. “Understand How COVID-19 affects PWH is important because approximately half of PWH >“People aged 50 years have higher rates of comorbidities compared to people without HIV (PWOH).”

Reinfection rate 6.7% vs 5.2%

A total of 5.3% of 453,587 COVID-positive residents were reinfected, including 192 of 2,886 PWH (6.7%) and 23,642 of 450,701 PWOH (5.2%). The reinfection rate among PWH was 66 per 1,000 person-years and among PWOH was 50 per 1,000 person-years. The adjusted COVID-19 reinfection rate for PWH (1.46 cases per 1,000 person-years) was higher than PWOH.

Among residents who were reinfected, PWH were older (median age 43 years) than PWOH (median age 36 years). Relative to PWOH, PWH were more likely to be male (79.3% vs 40.9%) and black (53.7% vs 27.0%), and to have received both the primary COVID-19 vaccine series and the booster vaccine (31.8% vs 22.1%). Among those who were reinfected, PWH were less likely than PWOH to be unvaccinated at the time of first infection (87.5% vs 91.0%).

People living with HIV should follow the recommended COVID-19 vaccination schedule, including booster doses, to avoid reinfection with SARS-CoV-2.

131,682 residents were vaccinated before their first SARS-CoV-2 infection, 54.2% of whom had completed the Pfizer/BioNTech primary vaccine series. Of the 23,834 residents who were reinfected, 39.6% (9,444 of 23,834 residents) had completed the primary series but did not receive a booster immunization before reinfection.

Reinfection rates were consistently higher among PWH than among PWOH, regardless of mutation wave and calendar quarter. The highest incidence of PWH occurs during periods when Omicron strains are dominant (50 cases per 1,000 person-years). Overall, more than 16 reinfections were reported per 1000 person-years of infection.

“PWH should follow the recommended COVID-19 vaccination schedule, including booster doses, to avoid reinfection with SARS-CoV-2,” the authors wrote.

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