Risk of HIV viral rebound after SARS-CoV-2 infection among people living with HIV on antiretroviral therapy: a retrospective matched cohort study

Background: There are few studies that describe the impact of SARS-CoV-2 infection on HIV outcomes. We aimed to assess the viral adverse changes associated with SARS-CoV-2 infection in PLHIV. Research design and methods: This retrospective cohort study enrolled 3327 PLHIV on ART. Baseline information was collected through questionnaires and electronic health records. PLHIV with and without SARS-CoV-2 infection (reference) were propensity score matched. The association between SARS-CoV-2 infection and HIV viral rebound was assessed by using log-binomial regression models, with relative risks estimated. Results: We included 446 PLHIV without SARS-CoV-2 infection and 446 PLHIV with SARS-CoV-2 infection after matching. Compared to PLHIV without SARS-CoV-2 infection, PLHIV with SARS-CoV-2 infection had relatively higher HIV VLs (75th percentile: 105 versus 51 copies per mL; 80th percentile: 257 versus 196 copies per mL; 90th percentile: 5170 versus 2360 copies per mL). PLHIV infected with SARS-CoV-2 had a significantly increased risk of viral rebound (RR of 1.32, 95% confidence interval [CI]: 1.25, 1.40). The risk was higher among males than females but was comparable across age groups. Similar patterns were observed for secondary outcomes. Conclusions: These findings suggest that SARS-CoV-2 infection is a risk factor for viral rebound in PLHIV on ART.