COVID-19 Coinfection and Vaccination Profile Amongst People with HIV/AIDS (PWHA) in Indonesia: a Preliminary Study

Sasfia Candrianita¹, Rudi Wisaksana^1,2, Yovita Hartantri^1,2, Uun Sumardi^1,2, Susantina Prodjosoewojo^1,2, Marita Restie Tiara¹, Primal Sudjana^1,2, Bachti Alisjahbana^1,2

¹Internal Medicine Department, Faculty of Medicine Universitas Padjadjaran / Hasan Sadikin General Hospital, Bandung, Indonesia

²Tropical Disease and Infection Division, Internal Medicine Department, Faculty of Medicine Universitas Padjadjaran / Hasan Sadikin General Hospital, Bandung, Indonesia

Abstract

Introduction

                COVID-19 pandemic that has been occurred for more than two years yields a huge impact for PWHA population. Due to their immunocompromised status, PWHA have greater risk of being coinfected with COVID-19. COVID-19 vaccine as a preventive way of SARS CoV-2 virus transmission has been administered for the PWHA, however the epidemiological studies remain limited.

Method

                This was the first cross-sectional study in Indonesia, analysing COVID-19 coinfection and vaccination coverage in the PWHA population. A total of 307 PWHA who came to the HIV Clinic, Hasan Sadikin General Hospital were included in this study. The data regarding social history, HIV medical history, comorbidity, as well as COVID-19 coinfection and vaccination was obtained from both anamnesis and medical record. The patients` sera were obtained for IgG and IgM SARS CoV-2 rapid test analyses. Analyses were conducted using SPSS version 20, utilising Chi-square test for descriptive analysis.

Results

                Three-hundred and seven PWHA from the total of 1971 patients in the HIV clinic during June 2021 – November 2021 period were included. The median age of the patient was 37 (35 – 38) years. Men dominated the PWHA population (230 people, 75%) with male have sex with male as the key population (100 people, 32.4%). On average, the PWHA were on the stadium I HIV (298 people, 96.4%), with 24.3% (75 people) had pulmonary TB coinfection and 7.1% (22 people) had extrapulmonary TB coinfection. Majority of the patients have CD4 > 200 (20.4%) and undetected viral load (13.9%). The patients consumed antiretroviral therapy daily (305 people, 98.7%). There were 13.6% (48 people) of PWHA with COVID-19 coinfection history. First-dose vaccination has been administered within 78.6% (246 people) PWHA, whereas there were 59.5% (188 people) PWHA who received second-dose vaccination. Rapid tests showed positive IgG SARS CoV-2 in 55% (170 people) PWHA, nevertheless IgM SARS CoV-2 was detected in 1.9% (6 people) PWHA. There was 61.3% seroconversion of the SARS CoV-2 IgG antibody following COVID-19 first-dose vaccination (p-value <0.05).

Discussion

Immunocompromised status of the PWHA renders the population towards vulnerability of having secondary infection. The COVID-19 infection risk in the PWHA population is somewhat similar to the general population. First-dose vaccination coverage in the PWHA impressively surpassed the national coverage target (>70%), though in the beginning of the pandemic there was hesitancy to complete the vaccination. Vaccination was significantly associated with seroconversion towards IgG SARS CoV-2 antibody in the PWHA population.

Conclusion

This was the first epidemiological study regarding COVID-19 coinfection and vaccination in the PWHA population in Indonesia. COVID-19 vaccination is recommended for the PWHA population.

Keywords: Antibody, COVID-19, HIV, PWHA, Vaccine