A report released by the World Health Organisation in July 2021 has confirmed that being HIV positive is a huge risk factor for both severe and critical COVID-19 patients. This means that one is more likely to die from COVID-19 if he/she is an HIV positive patient.
The report said nearly a quarter (23.1%) of all people living with HIV who were hospitalized with COVID-19, died. WHO said the report is based on clinical surveillance data from 37 countries regarding the risk of poor COVID-19 outcomes in people living with HIV (PLHIV) admitted to hospitals for COVID-19.
“People living with HIV have an increased risk for severe disease from COVID as well as hospitalisation. And then once hospitalised, have a 30 per cent increased risk of death,” said Dr Meg Doherty, WHO Director HIV, Hepatitis and STI Programmes, as part of World Health Organisation’s Science in 5 series.
W H O findings say that the risk of developing severe or fatal COVID-19 was 30% greater compared to people without HIV infection while people with underlying conditions such as diabetes and hypertension who are over 65 years have an increased risk of more severe and fatal COVID-19.
As fatal as it may be, a person living with HIV and has other underlying conditions listed above are at greater risk of death than any other person. But why are people living with HIV at an increased risk for severe disease from COVID?
Can HIV positive people take the COVID-19 vaccine? Are current COVID vaccines safe for HIV patients? WHO officials and other experts explain the link between COVID-19 and HIV.
Explaining why people living with HIV (PLHIV) may have a worse COVID-19 infection, Dr Monalisa Sahu, Consultant Infectious Diseases, Yashoda Hospitals, Hyderabad said “It could be due to the presence of immune dysregulation, higher prevalence of medical comorbidities and presence of an ageing population.”
Dr Mala Kaneria, Consultant Department of Infectious Diseases, Jaslok Hospital, Mumbai agreed with the position.
“People living with HIV are prone to severe COVID illness if infected. This is particularly so in those with advanced AIDS and lower CD4 counts. The fact that COVID causes lymphocytopenia (a disorder in which your blood doesn’t have enough white blood cells called lymphocytes) just like HIV, makes this co-infected population vulnerable to flaring up of latent infections, which can contribute to mortality. Also, the radiological appearance of many opportunistic infections in HIV is mimicked by COVID, thus delaying the diagnosis of either infection.”
Before now, a treatment called antiretroviral therapy (ART) that involves taking a combination of HIV medicines is recommended for PLHIV however, during the COVID pandemic, a reduction in access to prevention and testing services for HIV was reported, said Dr Doherty.
Are COVID-19 Vaccines Safe For People Living With HIV?
According to WHO, many of the COVID-19 vaccine studies have included a small number of people living with HIV in their trials. Despite limited data, available information suggests current WHO-recommended COVID-19 vaccines (AstraZeneca/Oxford, Johnson and Johnson, Moderna, Pfizer/BioNTech, Sinopharm and Sinovac) are safe for people living with HIV.
The currently available vaccine products are not live vaccines, they include genetic material from SARS-CoV-2 which cannot replicate, medical experts, say. Therefore, these vaccines are not expected to be less safe in people who are immunocompromised. In addition to this, no pharmacological interactions have been reported between COVID-19 vaccines and antiretroviral medications which people living with HIV should continue to take after vaccination to maintain health, states WHO.
Echoing the same, Dr Sahu said, currently available COVID-19 vaccines in India are believed to be safe for most people, including the population living with HIV. These vaccines have the same benefits in the PLHIV, like that in the other individuals, as prevention of severe disease and potentially reduced transmission of the SARS-CoV-2, she said.
Health Experts explained that in PLHIV, CD4 count that measures the robustness of the immune system is used to see how well a person is responding to medication. An increase or decrease in CD4 count depicts the improvement and progression in the infection.
Dr Doherty “All persons should be in line for vaccines.”
This story is supported by Journalists for Human Rights under the Mobilizing Media to Fighting Covid-19 project.