HIV and COVID-19 Disease

Abstract

Despite effective antiretroviral therapy (ART), HIV infected individuals throughout the world remain at significant risk of respiratory infections and non-communicable disease. Severe disease from SARS-CoV-2 is associated with a hyperinflammatory phenotype which manifests in the lungs as pneumonia and in some cases can lead to acute respiratory failure. Progression to severe COVID-19 is associated with comorbid disease such as obesity, diabetes mellitus and cardiovascular disease, however data concerning the associated risks of HIV coinfection are still conflicting, with large population studies demonstrating poorer outcomes, whilst smaller, case-controlled studies showing better outcomes. Furthermore, underlying immunopathological processes within the lungs and elsewhere, including interactions with other opportunistic infections (OI), remain largely undefined. Nonetheless, new and repurposed anti-viral therapies and vaccines which have been developed are safe to use in this population, and anti-inflammatory agents are recommended with the caveat that the coexistence of opportunistic infections is considered and excluded. Finally, HIV infected patients remain reliant on good ART adherence practices to maintain HIV viral suppression, and some of these practices were disrupted during the COVID-19 pandemic, putting these patients at further risk for acute and long-term adverse outcomes.

Evolution of HIV Health Care Workforce Needs in the U.S. Mountain West During the COVID-19 Pandemic: A Mixed Method Study

“…Emerging evidence suggests an association between HIV infection and risk for severe COVID-19 illness and mortality, especially in people with advanced HIV disease and in underserved groups (Bertagnolio et al, 2022; Tesoriero et al, 2021). The pandemic necessitated social distancing practices that caused many clinics to literally close their doors and impeded PWH's access to needed services (Venturas, 2023). Patterns of COVID-19 morbidity and mortality revealed significant social and racial inequities and focused attention on persistent health disparities within the United States that were already well described among PWH.…”

SARS-CoV-2 antibodies in adolescents living with perinatally acquired HIV

“…Adolescents living with perinatally acquired HIV (ALPHIV) may be at increased risk of severe COVID-19 disease because of comorbidities such as chronic lung disease or metabolic complications resulting in poor glycaemic control. 3 Traditional risk factors for COVID-19 include high body mass index, diabetes, chronic lung disease and renal disease. Adolescents living with perinatally acquired HIV have been shown to have a higher burden of many of these conditions.…”