Registry will examine ‘natural history’ of COVID-19 in patients with HIV
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The Coronavirus Under Research Exclusion, or CURE, HIV-COVID registry — www.hivcovid.org — is an institutional review board-approved registry that has been developed by experienced HIV providers from Arizona Liver Health in Chandler, Arizona, and the University of Maryland, Baltimore, to capture real-time information from providers all over the United States about patients with HIV who have contracted COVID-19. Our goal is to help elucidate the natural history of COVID-19 in patients with HIV, determine the effects of treatments and analyze the impacts of factors like age, CD4 count and comorbidities on COVID-19 outcomes. Updates are published biweekly and shared with providers around the world to expedite the understanding of COVID-19 in this patient population.
We were motivated by registries launched by rheumatology, inflammatory bowel disease and dermatology consortiums in an effort to collect data on COVID-19 as it pertains to their respective patient populations. Their innovative information-gathering strategy and timely dissemination of information to colleagues treating these specific patient subpopulations influenced the establishment of the HIV-COVID-19 registry. As of this time, there are limited data regarding whether people living with HIV (PLWH) are at an increased risk for COVID-19 or if any modifications in treatment or management are warranted. There are, however, distinct issues regarding potential drug-drug interactions with new COVID-19 therapies and ART. The CDC does note that the risk in PLWH who are coinfected with the COVID-19 virus may be greater in those who are not being treated with ART and/or in those who have a low CD4 cell count.
Currently, we have entered at least 34 reported cases in the registry from different states across the country, a number that increases daily. The data we included have various patient outcomes based on factors such as the patient’s CD4 cell count, age, gender, race and type of COVID-19 treatment received. These outcomes include, but are not limited to, hospitalization rate, ventilator use, recovery, ongoing hospitalization and death. That information can be obtained at www.hivcovid.org/current-data/.
Reporting a case to the registry takes approximately 5 minutes. Providers are encouraged to report all cases of COVID-19 among PLWH regardless of severity; this includes asymptomatic cases detected through public health screening. Although we are currently collecting data only from within the U.S., we have hopes that the registry will be launched internationally in the near future. In addition, we are implementing a patient-centered survey to gain a better understanding of the impact of COVID-19 on mental health, HIV treatment, adherence to medication and access to care, participation with quarantining and/or other social distancing guidelines and socioeconomic factors. These data, we hope, will help inform patient advocacy groups, case managers and others involved in the care of this population and their changing needs during this global pandemic.
- References:
- CDC. What to know about HIV and COVID-19. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/hiv.html. Accessed May 26, 2020.
- International AIDS Society. COVID-19 and HIV: What you need to know. https://www.iasociety.org/covid-19-hiv. Accessed May 26, 2020.
- For more information:
- Anita Kohli, MD, MS, is director of research at Arizona Liver Health in Chandler, Arizona, and an adjunct faculty member in the University of Arizona Mel & Enid Zuckerman College of Public Health in Tucson, Arizona. She can be reached at akohli@azliver.com.
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