Patients Receiving Nucleoside Reverse Transcriptase Inhibitors at Lower Risk of COVID-19

The results of a recent cohort study show that patients with HIV who are taking tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) are at a lower risk of contracting coronavirus disease 2019 (COVID-19) than patients receiving other therapies.

Investigators analyzed the health records of 77,590 HIV-positive patients receiving antiretroviral therapies (ART) at HIV clinics in 60 Spanish hospitals between February 1 and April 15, 2020. Of the 77,590 patients, 236 were diagnosed with COVID-19, 151 were hospitalized, 15 were admitted to intensive care, and 20 died. The study authors found that the risk of COVID-19 diagnosis and hospitalization were greater in men and patients older than 70 years.

When analyzing the types of ART among the patient population, the investigators found that the risk for COVID-19 hospitalization was 20.3 among patients receiving tenofovir alafenamide and FTC; 10.5 among patients receiving TDF and FTC; 23.4 among patients receiving abacavir and lamivudine; and 20.0 among patients receiving other ART regimens. The risks for COVID-19 diagnosis were 39.1, 16.9, 28.3, and 29.7, respectively. Notably, no patient receiving TDF and FTC was admitted to intensive care or died.

Based on these findings, the investigators said HIV-positive patients receiving TDF and FTC have a lower risk for both COVID-19 diagnosis and hospitalization than those receiving other ART. They concluded that these findings warrant further research in HIV preexposure prophylaxis studies and randomized trials in patients both with and without HIV.

REFERENCE

Amo J, Polo R, and Moreno S. Incidence and severity of COVID-19 in HIV-positive persons receiving antiretroviral therapy: a cohort study. Ann Intern Med.2020;173(7):536-541doi:10.7326/M20-3689