COVID-19 and HIV co-infection

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Main article: COVID-19

For COVID-19 frequently asked inpatient questions, click here

For COVID-19 frequently asked outpatient questions, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Harmeet Kharoud M.D.[2]

Synonyms and keywords:

Overview

• An observational prospective study found out that the incidence of HIV-infected individuals to be affected by SARS-CoV-2 was similar to the general population.
• Specific antiretroviral therapy did not affect COVID-19 severity.
• Immunosuppression(low CD4 cell counts) was associated with COVID-19 severity.
• Patients with HIV infection often have other comorbidities(lung disease, cardiovascular disease) therefore, increasing the risk for severe-COVID-19 disease.
• Patients with HIV infection with CD4 cell count<200/mm3 are at increased risk for complications from other respiratory infections. However, we do not know if this is the scenario with COVID-19.

Epidemiology and Demographics

Risk

• At present people with HIV who are at greatest risk of Severe COVID-19 infection are people -
  • who have lowCD4 cell count.
  • not on antiretroviral therapy.

Presentation

• There hasn't been any observable difference in clinical presentation among people with HIV infection as compared to the general population.
• Common symptoms for COVID-19 are
  • Fever or chills
  • Cough
  • Shortness of Breath or difficulty breathing
  • Fatigue
  • Muscle or Body aches
  • Headache
  • New loss of taste or smell
  • Sore Throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

Specific Populations with HIV

Pregnancy

• Pregnant individuals with HIV are at greater risk for severe illness, morbidity, or mortality as compared with the general population due to coronavirus infections(SARS-CoV and MERS-CoV) and other viral respiratory infections like influenza. Data related to COVID-19 is limited but pregnant individuals with HIV are suspected to be at greater risk due to SARS-COV-2 similarity with other coronaviruses (SARS-CoV and MERS).
• They are suspected to be at increased risk of preterm delivery, adverse neonatal outcomes, however, data is very limited.<refhttps://s3.amazonaws.com/cdn.smfm.org/media/2267/COVID19-_updated_3-17-20_PDF.pdf </ref>

Recommendations for Patients with HIV

• Maintain the supply for antiretroviral therapy for a minimum of 30 days.
• Virtual visit and telemedicine should be considered for non-urgent care and non-adherence counseling
• People with suppressed HIV viral load and in stable health, should postpone their routine medical care and laboratory visits to the extent possible.
• If they develop symptoms of COVID-19 like fever, cough, shortness of breath, etc they should seek medical advice.
• They should make sure their vaccination status is updated.