A team of South African scientists have found that those living with advanced HIV and Aids could be at a greater risk of Covid-19 infection and have a longer recovery period. They argue that their findings could be a justification for those with HIV to be prioritised for a Covid-19 vaccine.
The article was published by the Kwazulu-Natal Research Innovation and Sequencing Platform (KRISP).
Professor Alex Sigal, Africa Health Research Institute (AHRI) faculty member and associate professor at the University of KwaZulu-Natal, said the study aimed to understand the effects of HIV on people with Covid-19.
“We've learned that people with HIV can also deal well with Covid-19. However, there are exceptions and the exceptions are people with advanced HIV where it has been uncontrolled for a long time,” he said.
In cases where HIV had been uncontrolled and where antiretrovirals were not taken properly, the body’s T cells begin to deplete. These cells are an important line of defence against Covid-19.
“The bottom line is that you have to take care of the HIV infection, so it doesn't get to a stage where you have so much damage that your immune system cannot handle Covid-19,” said Sigal.
Authors in the study said evidence showed that HIV was associated with an increased risk of more severe disease and death from Covid-19.
“If persistent infection does occur more frequently in the context of HIV, it may provide justification for prioritising people living with HIV for Covid-19 vaccination,” said the authors.
“In the case described here, based on the very low CD4+ count, there was putative immunosuppression as a result of anti-retroviral treatment failure and HIV drug resistance. The impairment of both cellular and humoral adaptive immunity from HIV was obviously profound enough to delay clearance of Covid-19.”
Sigal said the study, which was conducted at UKZN, examined 244 people.
While most people with HIV were able to clear Covid-19 and recover, some with advanced HIV showed Covid-19 positivity that persisted up to 6 months, the researchers found.
“It's a battle between Covid-19 and the immune system. If the virus is not knocked out, it is going to evolve and when it does there is a resistance to antibodies. When that happens, you can get viruses with mutations and variants.”