HIV and SARS-CoV-2 Co-infection: Epidemiological, Clinical Features, and Future Implications for Clinical Care and Public Health for People Living with HIV (PLWH) and HIV Most-at-Risk Groups

Abstract

Purpose of ReviewThe purpose of this review is using the currently available clinical and epidemiological data, to identify key aspects to improve both the clinical management and public health response with regard SARS-CoV-2/HIV co-infection among HIV vulnerable populations and people living with HIV (PLWH).Recent Findings While at the beginning of the COVID-19 pandemic, the lack of robust information on SARS-CoV-2/HIV coinfection prevented to have a clear picture of the synergies between them, currently available data strongly supports the importance of common structural factors on both the acquisition and clinical impact of these infections and the relevance of age, co-morbidities, and HIV viral load as associated worse prognosis factors among PLWH. Summary Although more information is needed to better understand the biological, clinical, and epidemiological relationship between both infections, in the meanwhile, syndemic approaches to prevent SARS-CoV-2 among HIV higher risk groups and PLWH, targeting these population for SARS-CoV-2 vaccines and protocolizing early identification of HIV + patients with worse COVID-19 prognosis factors, are crucial strategies to decrease the overall impact of SARS-CoV-2 /HIV coinfection.

Fourth Dose of mRNA COVID-19 Vaccine Transiently Reactivates Spike-Specific Immunological Memory in People Living with HIV (PLWH)

“…As the latter are considered high-risk subjects for severe COVID-19, nowadays immunocompromised individuals are being administered with additional booster doses of eligible vaccines. People living with HIV (PLWH), with advanced HIV disease, lower CD4+ T cell counts or an unsuppressed HIV viral load are considered at high-risk, as the main hosts of HIV are CD4+ T lymphocytes, which orchestrate adaptive immunity responses and the immunological memory [ 2 , 3 ]. HIV is a retrovirus whose infection gradually deteriorates the functionalities of the immune response, as it induces a slow decrease of the CD4+ T cell pool and causes major gaps in the immune repertoire [ 4 ].…”

Associations between COVID-19 testing status, non-communicable diseases and HIV status among residents of sub-Saharan Africa during the first wave of the pandemic

“…One of the strengths of the study is the contribution to understanding the epidemiology of the COVID-19 pandemic in sub-Saharan Africa, a region with a high prevalence of HIV and a growing prevalence of non-communicable diseases. This study provides information about the COVID-19 related behavioural responses of persons with HIV infection and those with non-communicable diseases, which helps to better understand the biological, clinical, and epidemiological relationship between both infections [ 16 ]. The large sample size and the representation of all the sub-regions in sub-Saharan Africa make the findings reliable.…”

“…Prior studies have indicated that persons living with HIV are at higher risk of contracting and dying from COVID-19 infection [ 14 , 15 ] as both diseases have common biological, clinical, and epidemiological factors that affect the acquisition and clinical impact of these infections [ 16 ]. Also, people living with HIV are less likely to be vaccinated against COVID-19 [ 17 ] though vaccination uptake was better among those with chronic diseases [ 18 ].…”

SARS-CoV-2 Infection may be Prevented with Cytochrome Inhibitors: Cobicistat and Ritonavir

“…Since early in the COVID-19 pandemic, there has been a growing interest in exploring the impact of COVID-19 among people living with HIV (PLWH). Although initial studies assessing the severity of COVID-19 among PLWH do not suggest poorer outcomes, recent findings showed a higher risk of morbidity and mortality, particularly in those with lower CD4 cell counts, unsuppressed HIV viremia and comorbidities mentioned above (5,6). Still, it is debated whether PLWH have an increased risk of severe COVID-19, as the data come from cohort studies performed with unmatched populations.…”

“…The susceptibility of PLWH to SARS-CoV-2 infection has also been debated. The incidence of COVID-19 among PLWH ranges between 0.3-5.7% (5,8). Current data revealed that SARS-CoV-2 infection rates among PLWH are not higher than their HIV-negative counterparts (8,9).…”