COVID-19 and HIV:
HIV (human immunodeficiency virus) is a virus affecting the immune system of an individual. It leads to the development of AIDS (acquired immunodeficiency syndrome). This syndrome combines different clinical presentations primarily due to the patient's immunocompromised state. The infection can be controlled with proper medical care but has no effective cure. The history of HIV dates back to the 1800s when a possible virus transfer from chimpanzees to humans might have occurred (either by consuming the meat or contact with infected blood). The virus was known as the simian immunodeficiency virus (SIV) when it affected only chimpanzees.
SARS-CoV-2 is a coronavirus discovered in Wuhan, China, in 2019, and it spreads via respiratory droplets produced as the infected person coughs, talks, or sneezes. This virus causes Coronavirus disease (COVID-19), a respiratory disease. A few infected people may not present with symptoms. The patients show symptoms that might range from mild to severe. A severe form of the disease manifests in adults over 65 years and people with underlying comorbidities regardless of age. Vaccines play an essential role in reducing the spread of the infection. Vaccines are available to prevent or reduce the intensity of the infection for anyone above five years of age, and booster doses are available for people over 16 years.
Are People With HIV at Higher Risk of Developing COVID-19 Infection?
There is not enough scientific proof of the correlation between both infections. However, out of the 1.2 million people living with HIV in the United States, half of the patients are 50 years or older. HIV-positive patients live with a multitude of conditions owing to their immunocompromised state. These factors of the affected age group and associated health conditions make these patients more likely to develop severe complications if infected with SARS-CoV-2. A recent study by the World Health Organization, including data from 24 countries, reported an independent association between HIV and an increased risk of a severe and critical form of COVID-19.
Can an HIV Patient Safely Take the COVID-19 Vaccine?
Vaccine clinical trials were conducted by the Food and Drug Administration, including HIV patients, to assess the vaccine's effectiveness, safety, and manufacturing quality. The vaccines met the safety standards of the clinical trials and are recommended for everyone eligible. The dosage and number of shots depending on the type of vaccine received.
An additional primary shot at improving a person's immune response is recommended after completing the primary series of COVID-19 vaccines in patients who have advanced HIV or are not taking effective treatment for HIV. The additional primary shot should be taken before the booster shot. The additional primary shot is not recommended for virally suppressed HIV patients or those who do not have an advanced progression of the disease.
The booster shot is to be taken at the recommended time.
There is no evidence of the vaccine interfering with pre-exposure prophylaxis (PrEP), which is taken to prevent HIV, and with antiretroviral therapy (ART), which is used to treat HIV.
Can Pregnant and Breastfeeding HIV Patients Transmit COVID-19 to Their Babies?
Given that COVID-19 is a disease that evolved recently, the data available on the clinical presentations in specific populations (like, pregnant and breastfeeding women) is very little to conclude anything. Women with COVID-19 should be concerned about transmitting the infection to neonates through respiratory secretions. The Infants born to COVID-19 infected mothers must be protected by following the infection and prevention control precautions and should be fed according to standard infant feeding guidelines. COVID-19-infected mothers should practice respiratory hygiene by wearing a medical-grade mask, routinely cleaning and disinfecting surfaces, and washing or sanitizing hands before and after contact to prevent transmission to the child.
A recent study with an extensive database of pregnant women with COVID-19 conducted by the CDC suggested that these patients are more likely to need intensive care because of an increased relative risk of developing a severe infection. They are often treated with palliative therapies, given that the body undergoes immunologic and physiologic adaptations during and after pregnancy, and these events may overlap with COVID-19 symptoms. However, pregnant women who show COVID-19 signs must be tested promptly to give them access to specialized care early. If the infection is confirmed, they must be treated similarly to non-pregnant women and should be confined to isolation and rendered supportive care.
What Is the Treatment of COVID-19 for HIV-Positive Patients?
Though there has been active research and clinical trials to deduce a treatment regimen for COVID-19, there is no evidence of a working regimen to date. Treatment is palliative in nature. Antiretroviral agents used to treat HIV have no significance in treating COVID-19. HIV-positive patients are suggested to continue their antiretroviral treatment regimen without considering stopping or changing their medications to prevent or treat COVID-19. Patients requiring hospitalization can also continue the antiretroviral therapy along with treatment of opportunistic infections and prophylaxis when needed. If the clinicians need to adjust or switch the antiretroviral medications, they must consult with an HIV specialist before doing so.
Conclusion:
It is recommended that HIV patients continue their HIV medications and follow the recommendations by the CDC for the prevention of COVID-19. Maintaining a healthy immune system and lifestyle is essential.
-
HIV patients must ensure they have at least a 30-day (or longer) supply of HIV medications and any other medical supplies required for managing HIV.
-
All vaccinations must be up to date, including vaccinations against seasonal flu and bacterial pneumonia. These diseases that vaccines can prevent affect people with HIV more than others.
-
Choose telemedicine or remote clinical care options instead of hospitalization.
