TOPLINE:

Patients with HIV infection had a 29% higher risk of developing long COVID manifestations than those without HIV infection, with notably higher risks for nervous system disorders, mental health conditions, and respiratory issues.

METHODOLOGY:

• Researchers analyzed patients with COVID in South Carolina between March 2020 and January 2022 to compare the risk for long COVID manifestations between patients with and without HIV infection.
• Data from electronic health records of 838,520 patients were analyzed; 2662 of them had HIV infection (mean age, 46 years; 63.7% men) and 835,858 did not (mean age, 44.2 years; 44.6% men).
• Researchers grouped 131 potential long COVID categories through International Classification of Diseases, 10th Revision (ICD-10) codes into 13 organ/system groups, including diseases/disorders of the musculoskeletal, respiratory, genitourinary, circulatory, digestive, and nervous systems and abnormal clinical/laboratory findings.
• The primary outcome was a new diagnosis of long COVID, classified into the 13 groups, recorded 30-180 days after COVID.

TAKEAWAY:

• Patients with HIV infection had a higher prevalence of long COVID manifestations across any of the diagnosis groups (16.3%) than those without HIV infection (10.6%).
• Patients with HIV infection had a higher risk of developing long COVID manifestations across at least one of the diagnosis groups than those without HIV infection (adjusted hazard ratio [aHR], 1.29; 95% CI, 1.09-1.54).
• Patients with HIV infection had the highest risk of developing diseases of the nervous system (aHR, 2.04; 95% CI, 1.42-2.92), followed by mental/behavioral/neurodevelopmental disorders (aHR, 1.78; 95% CI, 1.12-2.82) and diseases of the respiratory system (aHR, 1.78; 95% CI, 1.18-2.69).

IN PRACTICE:

“Our study highlights the consistent and elevated LC [long COVID] burden in PWH [patients with HIV infection], emphasizing the importance of sustained follow-up for COVID-19 survivors to improve their clinical outcomes and prevent morbidity of LC,” the authors wrote.

SOURCE:

This study was led by Fanghui Shi, PhD, University of South Carolina, Columbia, South Carolina. It was published online on February 04, 2026, in the Journal of Acquired Immune Deficiency Syndromes.

LIMITATIONS:

This study relied on ICD-10 codes in electronic health records to identify patients with long COVID, which may have underestimated its true prevalence. It also lacked data on inflammatory markers and socioeconomic factors to explore biological and social drivers of the elevated risk among patients with HIV infection, and the predominantly Black population from urban areas may have limited generalizability.

DISCLOSURES:

This study did not receive any specific funding. The authors reported having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.