Are COVID-19 Outcomes Worse For People Living With HIV?
South Africa has the biggest HIV epidemic in the world, with close to 8 million people living with the disease. With South Africa having recorded over 373 628 cases of COVID-19 positive cases so far, it’s no surprise that there have been questions around how the virus plays out in those living with HIV.
New research – considered to be the largest study of a group of people who were both living with HIV and hospitalised with COVID-19 – looked to answer this question. According to the study, being HIV positive does not pose a bigger risk for worse COVID-19 outcomes.
Why you shouldn’t worry
The worst had indeed been assumed when no research into this had been done at all, and while the scientists don’t necessarily know why, they found that patients living with well-controlled HIV in their study population didn’t have any worse outcomes compared to a similar comparison group. The scientists did mention that more research would need to be done to confirm this.
“In conclusion, we found no differences in adverse outcomes associated with HIV infection for hospitalised COVID-19 patients compared to a similar comparison group,” the study concluded.
“Verification of this finding in other large cohorts is warranted to improve understanding of the impact of COVID-19 on people living with HIV. If confirmed, investigation of specific factors contributing to similar outcomes in this large group of patients with immune disturbance may provide greater insight into the pathogenesis of SARS-CoV-2.”
What you need to know
If people living with HIV have been anxious about what contracting COVID-19 would mean for them, this study should ease their fears.
“I’m telling [my patients] ‘look, take standard precautions, but there’s no reason to live in fear that having HIV is causing you to be more likely to die from COVID,” Dr Keith Sigel, lead researcher for the study, said in a statement.
“Although this, to date, is the largest study that’s been published that has a comparison group, many of the studies without comparison groups have shown a similar finding – that is reassuring.”
HIV awareness and education organisation Avert offers some other important points people living with HIV should take note of:
- Current evidence suggests that HIV is less of a risk factor for severe COVID-19 than other health conditions.
- People living with HIV not on treatment or virally suppressed may be at a greater risk.
- As with the general population, older people living with HIV and those with other underlying conditions should take extra precautions to prevent illness.
- Try to have at least 30 days’ supply of ART in your home. If possible, ask for three months.
The new list of underlying conditions that up your risk
The Centres for Disease Control and Prevention recently published a newly expanded list of underlying conditions that put individuals at an increased risk of getting severely ill from COVID-19. This came after the organisation reviewed published reports, pre-print studies and several other sources of data. Here’s the updated list:
- Chronic kidney disease
- Type-2 diabetes
- COPD (chronic obstructive pulmonary disease)
- Obesity (BMI of 30 or higher)
- Immunocompromised state (weakened immune system) from solid organ transplant
- Serious heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies
- Sickle cell disease
The CDC also included a list of other conditions that might increase an individual’s risk of severe COVID-19 illness:
- Cystic fibrosis
- Neurological conditions such as dementia
- Liver disease
- Pulmonary fibrosis
- Type-1 diabetes
- Cerebrovascular disease
They clarified that these lists are living documents that may be updated at any time as the science evolves.
New isolation guidelines for South Africans
The minister of health, Dr Zweli Mkhize, announced that the recommended isolation period for someone who tests positive for COVID-19 is now 10 days and no longer 14 days.
“The presence of a detectable virus when testing does not imply infectiousness – it has been proven that in mild cases, virus cultures are generally only positive for eight to nine days after symptom onset,” Dr Mkhize said in his statement.
“The duration of infectiousness in patients with severe disease is less well established. In general, patients with severe disease may continue to shed the virus at higher levels for longer periods than patients with mild disease.”
The new guidelines go as follows:
- An asymptomatic patient can end isolation 10 days after testing.
- A patient with mild disease can end isolation 10 days after the onset of the symptoms.
- A patient with severe disease can end isolation 10 days after clinical stability has been achieved.