Effects of HIV status and vaccination on long COVID conditions within an integrated health care system

COVID infection has been linked to long-term effects known as Long COVID Conditions (PCC), presenting within 30-120 days post-acute COVID infection. Few studies have focused on PCC incidence among people with HIV (PLWH). Additionally, the effect of vaccination, especially among PLWH, is unclear on the risk for PCC. We evaluate PCC incidence among PLWH compared with people without HIV (PWoH), as well as the effect of COVID vaccination, within an integrated closed healthcare system with high ascertainment of COVID-19 testing. Adult patients with a positive polymerase chain reaction test for COVID between 1/1/2020-1/31/2022 were matched PLWH to PWoH by month of test, age, race, sex, vaccination status, using 1:3 variable ratio matching. PCC was defined as presenting with at least one of 17 previously identified conditions incident in the 30-120 days post first positive test date. We determined the effect of COVID vaccination on subsequent development of PCC using an unmatched PLWH/PWoH population analyzed by multivariate regression modeling. We show that 749 PLWH matched to 2,236 PWoH for PCC incidence evaluation and 492 (PLWH) and 71,844 PWoH for vaccination analysis. PLWH have 25% higher risk of PCC than PWoH. Gastrointestinal and other nervous system disorders are significantly higher among PLWH. Vaccination has significant impact on acute-persistent PCC risk but not late incident PCC without impact by HIV status. PLWH have higher risk of PCC. Vaccination lowers persistent symptom risk, but not late incident PCC risk. Vaccination and vigilance for PCC is encouraged. Some people who get COVID-19 develop long-term health problems, known as Long COVID or post COVID conditions (PCC), which can appear one to four months after infection. However, little research has looked at the risk of developing these conditions in people living with HIV (PLWH), or whether COVID-19 vaccination reduces this risk. In this study, we compared the risk of PCC in people living with HIV and those without HIV. We found that people living with HIV had a slightly higher risk of developing PCC, especially conditions affecting the digestive system and nervous system. We also found that people who were not vaccinated had a higher chance of experiencing long-lasting symptoms, regardless of whether they had HIV. These findings may help guide future vaccination strategies and improve diagnosis of Long COVID. Horberg et al., compare the incidence of post-COVID conditions (PCC) among people living with HIV (PLWH) and those without HIV (PWoH), and assess the effect of COVID-19 vaccination in a large integrated healthcare system. PLWH have a 25% higher risk of PCC, particularly gastrointestinal and neurological conditions, while vaccination reduces persistent but not late incident PCC risk, regardless of HIV status.