Background In hospitalized people with HIV (PWH) there is an increased risk of mortality from COVID-19 among hospitalized PWH as compared to HIV-negative individuals. Evidence suggests that tocilizumab—a humanized monoclonal interleukin (IL)-6 receptor inhibitor (IL-6ri) antibody—has a modest mortality benefit when combined with corticosteroids in select hospitalized COVID-19 patients who are severely ill. Data on clinical outcomes after tocilizumab use in PWH with severe COVID-19 are lacking. Case presentation We present a multinational case series of 18 PWH with COVID-19 who were treated with IL-6ri’s during the period from April to June 2020. Four patients received tocilizumab, six sarilumab, and eight received an undocumented IL-6ri. Of the 18 patients in the series, 4 (22%) had CD4 counts < 200 cells/mm 3 ; 14 (82%) had a suppressed HIV viral load. Eight patients (44%), all admitted to ICU, were treated for secondary infection; 5 had a confirmed organism. Of the four patients with CD4 counts < 200 cells/mm 3 , three were treated for secondary infection, with 2 confirmed organisms. Overall outcomes were poor—12 patients (67%) were admitted to the ICU, 11 (61%) required mechanical ventilation, and 7 (39%) died. Conclusions In this case series of hospitalized PWH with COVID-19 and given IL-6ri prior to the common use of corticosteroids, there are reports of secondary or co-infection in severely ill patients. Comprehensive studies in PWH, particularly with CD4 counts < 200 cells, are warranted to assess infectious and other outcomes after IL-6ri use, particularly in the context of co-administered corticosteroids. Supplementary Information The online version contains supplementary material available at 10.1186/s12981-022-00430-x.
【초록키워드】 Corticosteroid, COVID-19, HIV, Corticosteroids, Hospitalized, Mortality, severe COVID-19, mechanical ventilation, Tocilizumab, Infection, sarilumab, outcome, CD4, ICU, Clinical outcome, Viral load, cells, Patient, Co-infection, receptor, inhibitor, monoclonal, hospitalized COVID-19 patient, Organisms, supplementary material, increased risk, HIV-negative, organism, severely ill patients, humanized, benefit, Comprehensive, died, required, eight, case sery, treated, suppressed, individuals, admitted to ICU, people with HIV, use of corticosteroids, with COVID-19, 【제목키워드】 outcome, clinical, IL-6 blockade, case sery, patients with COVID-19,