HIV-positive people on treatment are not more likely to have severe symptoms or die from COVID-19 than the general population

Many studies done around the world show that people with HIV/AIDS who are on treatment do not experience worsened COVID-19 symptoms or outcomes. Researchers who reviewed the current scientific studies available on this subject say the evidence shows HIV patients may be treated for COVID-19 like any other patient. 

Because people with HIV have weakened immune systems, researchers were concerned that they may suffer more severe illness and death during the COVID-19 pandemic. By looking at individual studies about how HIV/AIDS patients respond to COVID-19 infection and treatments, researchers hoped to draw general conclusions to help other researchers, governments and doctors decide how to treat HIV/AIDS patients who are also infected with COVID-19.  

They looked through research papers containing keywords like “HIV”, “AIDS”, “Coronavirus” and “COVID-19”, released between January and June, 2020. The researchers were specifically looking for reports about HIV positive individuals, or people with AIDS, who were on antiretroviral treatments and had tested positive for COVID-19. 

From their search, the researchers found 35 papers from 13 countries, with the first case of COVID-19 and HIV co-infection reported in China. 

They found that HIV/AIDS does not appear to make COVID-19 disease worse, and that newly diagnosed HIV patients mostly recovered from COVID-19. The researchers also found that the patients had common COVID-19 symptoms like cough, fever, shortness of breath, fatigue, loss of smell and taste, and diarrhoea. Only one patient had seizures. 

In general, HIV/AIDS individuals seem to respond to COVID-19 just like any other patient. However, COVID-19 risk increased only when patients had other diseases like hypertension, diabetes, obesity and kidney disease. 

The researchers also report that the HIV/AIDS drug, darunavir, does not prevent Coronavirus infection. Their search also revealed that co-infected patients who had kidney and liver transplants also recovered from COVID-19.  

The researchers caution that their conclusions may be biassed because they only found studies written in English. They recommend further studies on how COVID-19 interacts with other diseases like tuberculosis, and pneumonia, and how co-infections can affect patients’ mental health.

This review was compiled by researchers from South Africa, where HIV/AIDS remains a massive health burden.

Abstract

The world currently faces two ongoing devastating pandemics. These are the new severe acute respiratory syndrome coronavirus 2/coronavirus disease 2019 (SARS-CoV-2/COVID-19) and the prior human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) pandemics. The literature regarding the confluence of these global plagues expands at pace. A systematic search of the literature considering COVID-19 and HIV co-infection was performed.  After five months, from the beginning of the COVID-19 pandemic, there were at least thirty-five studies reported from thirteen countries. These ranged from individual case reports and series to cohort studies. Based on studies that could be extrapolated to the general population, co-infected individuals with suppressed HIV viral loads did not have disproportionate COVID-19 sickness and death. At least four patients, newly diagnosed with HIV recovered from COVID-19. Current evidence suggests that co-infected patients should be treated like the general population. This ongoing living systematic evidence map of contemporary primary SARS-CoV-2 and HIV co-infection research provides a platform for researchers, policy makers, clinicians and others to more quickly discover and build relevant insights.

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