Given the chronic immune activation and inflammatory milieu associated with long COVID and HIV, we investigated whether adults living with HIV have increased odds of developing long COVID compared to adults living without HIV; and assessed the prevalence of long COVID in adults living with HIV.
In this systematic review and meta-analysis, we searched PubMed, EMBASE, CINHAL and CENTRAL from inception until June 14th, 2024, for observational studies that measured the incidence and prevalence of long COVID in adults living with HIV. We used random-effects meta-analyses to measure the odds ratio (OR) of developing long COVID in adults living with HIV compared to adults living without HIV and conducted a sensitivity analysis including only studies with adjusted estimates. We performed a single-arm proportional meta-analysis to synthesise prevalence estimates using logit transformation and a sensitivity analysis using multilevel-mixed-effects logistic regression.
Adults living with HIV had 26% increased odds of developing long COVID compared to people living without HIV (OR:1·26, 95%CI: 0·74 to 2·14; 5 studies; 29,980 participants, τ2 = 0·24; low certainty). When accounting for confounding (adjusted estimates only), these odds increased to 64% (OR:1·64, 95%CI: 1·55 to 1·74; 3 studies; 26,798 participants τ2 = 0; high certainty). The prevalence of long COVID in adults with HIV was 44% (95%CI: 0·33 to 0·55, 9 studies; 13,214 participants; τ2 = 0·44, low certainty)
Our review suggests that the risk for worse health outcomes in adults living with HIV persists in the long-term after the acute SARS-COV2 infection stage.
Our findings highlight the need for increased recognition and education of healthcare providers and policy-makers to better support people living with both conditions and inclusive research to develop coordinated care pathways to provide more holistic, patient-centered care, for the management of long-COVID for all the people living with HIV.
HIV
disease prevalence
