{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T15:51:56Z","timestamp":1776873116335,"version":"3.51.2"},"reference-count":56,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,5,10]],"date-time":"2022-05-10T00:00:00Z","timestamp":1652140800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>During the COVID-19 pandemic, people living with HIV (PLWH) were considered to be at risk of worse COVID-19 outcomes once infected. However, the existing evidence is inconsistent. This systematic review and meta-analysis aimed to compare the risk of SARS-CoV-2 infection, severe COVID-19 symptoms, and mortality among PLWH and patients without HIV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The articles included studies published in PubMed, Medline, Embase, and Cochrane between December 1, 2019, and December 1, 2021. We included the original studies published in English focusing on observational studies assessing the risk of SARS-CoV-2 infection, severe COVID-19 symptoms, and mortality among PLWH. Four independent reviewers extracted data. STrengthening the Reporting of OBservational studies in Epidemiology-Modified (STROBE-M) checklist was used for quality assessment. For the results with heterogeneity I<jats:sup>2<\/jats:sup> &amp;gt;75%, a random-effects model was employed. Otherwise, a fixed-effects model was used. The risk of SARS-CoV-2 infection, severe COVID-19 symptoms, and mortality were compared with and without HIV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included a total of 32 studies and 71,779,737 study samples, of whom 797,564 (1.11%) were PLWH. Compared with COVID-19 patients without HIV infection, PLWH had comparable risk of SARS-CoV-2 infection (adjusted Risk Ratio=1.07, 95% CI: 0.53-2.16, I<jats:sup>2 =<\/jats:sup> 96%, study n=6, n=20,199,805) and risk of developing severe COVID-19 symptoms (aRR=1.06, 95% CI: 0.97-1.16, I<jats:sup>2 =<\/jats:sup> 75%, n=10, n=2,243,370). PLWH, if infected with SARS-CoV-2, were found to have an increased risk of mortality compared with people without HIV (aRR=1.30, 95% CI: 1.09-1.56, I<jats:sup>2 =<\/jats:sup> 76%, study n=16, n=71,032,659). This finding was consistent across different subgroup analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>PLWH are at increased risk of COVID-19 related mortality once infected. The local health system should, on the one hand, strengthen COVID-19 prevention and clinical management among PLWH to avoid infection and, on the other hand, sustain the HIV care continuum for PLWH for HIV management.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2022.864838","type":"journal-article","created":{"date-parts":[[2022,5,10]],"date-time":"2022-05-10T12:57:33Z","timestamp":1652187453000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":37,"title":["Systematic Review and Meta-Analyses of The Interaction Between HIV Infection And COVID-19: Two Years\u2019 Evidence Summary"],"prefix":"10.3389","volume":"13","author":[{"given":"Yehua","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yewei","family":"Xie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siyue","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Ai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusha","family":"Tao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huilin","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fengshi","family":"Jing","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weiming","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,5,10]]},"reference":[{"key":"B1","unstructured":"Timeline of ECDC's Response to COVID-19"},{"key":"B2","unstructured":"Coronavirus Disease (COVID-19) Weekly Epidemiological Update and Weekly Operational Update"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2020.06.036","article-title":"CD4+T, Cd8+T Counts and Severe COVID-19: A Meta-Analysis","volume":"81","author":"Zhang","year":"2020","journal-title":"J Infect Dis"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiaa380","article-title":"Clinical Outcomes and Immunologic Characteristics of Coronavirus Disease 2019 in People With Human Immunodeficiency Virus","volume":"223","author":"Ho","year":"2021","journal-title":"J Infect Dis"},{"key":"B5","unstructured":"Global HIV & AIDS Statistics \u2014 2020 Fact Sheet"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2020.102139","article-title":"Rethinking High-Risk Groups in COVID-19","volume":"42","author":"Vishnevetsky","year":"2020","journal-title":"Mult Scler Relat Disord"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41598-021-85359-3","article-title":"Epidemiology and Outcomes of COVID-19 in HIV-Infected Individuals: A Systematic Review and Meta-Analysis","volume":"11","author":"Ssentongo","year":"2021","journal-title":"Sci Rep"},{"key":"B8","volume-title":"The Interaction Between HIV Infection and COVID-19: A Systematic Review and Meta-Analysis","author":"Wang","year":"2020"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e1000097","DOI":"10.1371\/journal.pmed.1000097","article-title":"Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement","volume":"6","author":"Moher","year":"2009","journal-title":"PloS Med"},{"key":"B10","unstructured":"Clinical Management of COVID-19: Interim Guidance"},{"key":"B11","doi-asserted-by":"crossref","DOI":"10.1002\/9781119536604","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Higgins","year":"2019"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f7450","article-title":"Converting an Odds Ratio to a Range of Plausible Relative Risks for Better Communication of Research Findings","volume":"348","author":"Grant","year":"2014","journal-title":"Bmj"},{"key":"B13","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1016\/j.socscimed.2017.05.049","article-title":"The \"Hispanic Mortality Paradox\" Revisited: Meta-Analysis and Meta-Regression of Life-Course Differentials in Latin American and Caribbean Immigrants' Mortality","volume":"186","author":"Shor","year":"2017","journal-title":"Soc Sci Med"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2019-053999","article-title":"Pregnancy and Fertility-Related Adverse Outcomes Associated With Chlamydia Trachomatis Infection: A Global Systematic Review and Meta-Analysis","volume":"96","author":"Tang","year":"2020","journal-title":"Sex Transm Infect"},{"key":"B15","doi-asserted-by":"publisher","first-page":"e297","DOI":"10.1371\/journal.pmed.0040297","article-title":"Strobe Initiative. 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