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HIV/AIDS is an infection caused by the Human Immunodeficiency Virus. The virus attacks and weakens the person’s immune system, making them prone to opportunistic infections - infections that are less likely to affect or cause serious complications in healthy individuals. 

Since immunocompromised people are said to be most at risk for the severe symptoms of COVID-19, it is only natural to worry if you are HIV-positive or have HIV/AIDS (or if a loved one has any of these health conditions).

Remember that HIV-positive people can live a long life with their medicines. Doctors were even considering the use of antiretroviral HIV drugs lopinavir boosted with ritonavir for treating COVID-19 at one point. (Albeit, the studies were small and conducted with participants who were HIV-negative.) 

That said, you are right to wonder if HIV patients are affected by COVID-19 to the same extent as those with lung disease or heart disease. And if there is anything specific an HIV patient needs to know about COVID-19 or any special prevention steps that they need to take.

Here is what is known so far about the impact of COVID-19 on HIV patients.

  1. How COVID-19 affects HIV patients
  2. COVID-19 and HIV drugs
  3. COVID-19 prevention tips for HIV positive people
  4. Doctors for What HIV/AIDS patients need to know about COVID-19

HIV patients with a high viral load and low CD4+ count (less than 200 cells per cubic millimetre of blood) - have advanced HIV infection or AIDS. HIV/AIDS patients who are not on antiretroviral therapy are at higher risk of contracting any and all infections. They are also at higher risk of complications of respiratory diseases, as per the US Department of Health and Human Services.

COVID-19 is a highly contagious viral infection which produces respiratory symptoms like shortness of breath. The more serious symptoms of this disease include pneumonia. CD4 is the immune system cell that HIV targets specifically. The CD4 count in people who don't have HIV infection is between 500 to 1500 cells/mm3 but in the case of HIV/AIDS, this count can fall below 200 cells per mm3.

So, are HIV-positive people at greater risk?

According to the World Health Organization (WHO), there is no evidence of an increased risk of COVID-19 in HIV patients who are already taking antiretroviral drugs. Though, older individuals and those with chronic diseases are at risk.

In China, a case study was done on an HIV-positive person who recovered from COVID-19. The patient also had diabetes and was being treated with antiretroviral drugs lopinavir and ritonavir and metformin. (Read more: Why COVID-19 is more dangerous for diabetics

A prepublication study argues that since HIV-positive people are immunocompromised, they don’t get as much inflammation as a healthy person would in response to the COVID-19 virus - SARS-CoV-2. (Inflammation is a part of our immune system's natural response to an infection or injury.)

For this reason, the prepublication study adds, they do not have clinical symptoms of the disease. The study also suggests that antiretroviral drugs and corticosteroids may be helpful in preventing or treating COVID-19.

However, the WHO has advised against the use of corticosteroids for COVID-19 since there is scientific evidence on their ineffectiveness, and regular use is associated with side effects.

Read more: Who can get tested for COVID-19

Antiretroviral drugs are given to HIV patients to control the viral load in their body. These drugs do not kill the virus but block the viral replication cycle. The WHO recommends immediate administration of antiretroviral therapy to anyone diagnosed with HIV irrespective of what their CD4+ count is.

Currently, the use of antiretroviral drugs in the prevention or treatment of COVID-19 is controversial. A recent study published in The New England Journal of Medicine indicated that lopinavir and ritonavir are not as effective against COVID-19.

That said, a British National in India was treated successfully with this combination and both these drugs are candidates in the multi-country SOLIDARITY trial launched by WHO to find therapies and treatment for COVID-19.

Read more: COVID-19 FAQs

The International AIDS society recommends that HIV patients take all the precautions that a healthy person needs to take for COVID-19. That is:

In addition to these:

  • HIV and AIDS patients should also keep on taking their routine medications to maintain their immunity.
  • Also, if you are HIV-positive and are not on antiretroviral drugs yet, start the treatment as soon as possible.
  • Buy and keep one month's supply of antiretroviral medications - or even three to six months' worth - where possible.
  • Those who are at risk of getting HIV should get tested for it. Make sure to call in advance to set an appointment with the clinic or testing faculty.
  • If you are an HIV-positive person with another chronic disease, make sure to take all your medications for the other disease too since older people and those chronic diseases are particularly at risk of getting the more severe COVID-19 symptoms.

Read more: COVID-19 prevention tips for older adults and those with chronic diseases

sunil Garkoti

sunil Garkoti

AIDS/HIV Sexually Transmitted Infections
2 Years of Experience

Dr. Kiran Anaparthi

Dr. Kiran Anaparthi

AIDS/HIV Sexually Transmitted Infections
8 Years of Experience

Dr. Govind Ram Tanwar

Dr. Govind Ram Tanwar

AIDS/HIV Sexually Transmitted Infections
37 Years of Experience

Dr. Prakash Trivedi

Dr. Prakash Trivedi

AIDS/HIV Sexually Transmitted Infections
21 Years of Experience

Medicine NamePack SizePrice (Rs.)
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AnovateANOVATE OINTMENT 20GM90.0
Pilo GoPilo GO Cream67.5
Proctosedyl BdPROCTOSEDYL BD CREAM 15GM66.3
ProctosedylPROCTOSEDYL 10GM OINTMENT 10GM63.9
RemdesivirRemdesivir Injection15000.0
Fabi FluFabi Flu 200 Tablet1292.0
CoviforCovifor Injection5400.0
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References

  1. AIDS Info [Internet]. National Institute of Health. U.S. Department of Health and Human Services. Maryland. US; Interim Guidance for COVID-19 and Persons with HIV
  2. Zhu Feng, Cao Yang, Xu Shuyun, Zhou Min. Co‐infection of SARS‐CoV‐2 and HIV in a patient in Wuhan city, China. Journal of Medical Virology. 2020: 1-2.
  3. Guo Wei, et al. A Survey for COVID-19 Among HIV/AIDS Patients in Two Districts of Wuhan, China. Preprints with The Lancet. 2020 March.
  4. World Health Organization [Internet]. Geneva (SUI): World Health Organization; Q&A on COVID-19, HIV and antiretrovirals
  5. US Department of Veteran Affairs [Internet]. Washington DC. US; CD4 count (or T-cell count).
  6. Bin Cao, et al. A Trial of Lopinavir–Ritonavir in Adults Hospitalized with Severe Covid-19. New England Journal of Medicine. 2020 March: 1-19.
  7. International AIDS Society [Internet]. Geneva. Switzerland; COVID-19 and HIV: What you need to know
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