Are People with HIV more at Danger from Coronavirus?

April 3, 2020
Although there isn't much information about this issue, it seems that people with HIV are not particularly vulnerable to COVID-19, nor are they among the patients who tend to have complications. However, just like everyone else, they still need to take care of themselves.

While the world is currently facing the coronavirus pandemic, the Acquired Immunodeficiency Syndrome (AIDS) pandemic remains active. Currently, there are about 40 million people with HIV in the world. Many of them are wondering if they’re particularly at risk of contracting COVID-19 and if they belong to the segment that develops serious complications.

There isn’t much information on this at this time. However, in early March, the 27th Conference on Retroviruses and Opportunistic Infections (CROI 2020) took place virtually. At that conference, they presented the only known high-level report to date on the subject of HIV/SARS-CoV2 co-infection.

The information provided by the experts indicates that people with HIV are not particularly at risk in the coronavirus pandemic. This means that they are neither more or less likely to become infected. Nor do experts consider them to have more complications than those who don’t have AIDS.

People with HIV are not at greater risk

What we can say is that, so far, there isn’t enough evidence to show whether people with HIV are particularly at risk from the coronavirus when compared to others. However, we should stress here that researchers are continually making new findings. So, because of that, there’s nothing conclusive so far, except for the experience gathered thus far.

On the subject of people with HIV and the coronavirus, we only have one documented case, which was in China. This doesn’t mean that there haven’t been other cases, of course. However, this is the only one that has scientists have followed up and which has given rise to a scientific publication.

The case concerns a 61-year-old Chinese man in Wuhan. He was diagnosed with HIV, but also suffered from type 2 diabetes and was a chronic smoker. He consumed between 20 and 30 cigarettes a day. At the time of his admission to the hospital, doctors confirmed his HIV diagnosis and discovered that he was in a state of severe immunosuppression.

The man received a 12-day course of lopinavir/ritonavir to treat COVID-19, along with other medications to address additional conditions. Surprisingly, the patient recovered and was discharged. He remained in quarantine for two more weeks and, in the end, tested negative for coronavirus.

A doctor with a test tube.
A man in Wuhan was diagnosed with HIV and coronavirus and is the only known case so far.

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Doctors advise caution

However, we can’t assume anything from just one case. However, since there have been no reports of particular problems with COVID-19 in people with HIV, there doesn’t appear to be a special risk of infection or complications.

Nevertheless, experts in the field have made some special recommendations. The first is that people with HIV who are on antiretroviral treatment should zealously follow the treatment guidelines. In particular, they emphasize that these people’s medication is for their exclusive use and shouldn’t be shared with anyone.

Apart from that, the advice is that people with HIV should follow the same guidelines as those given to everyone else. In particular, to respect the lockdowns and other restrictions, to maintain social distancing rules, and to wash their hands frequently. Also, older people and those with other chronic diseases should be especially careful.

Some tablets.
Antiretroviral treatments should not be discontinued or shared

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Myths and facts

Since there has been no special incidence of coronavirus in those with HIV, rumors and false information have begun to circulate. These only create confusion. Some people have said that, for example, antiretroviral treatment prevents a person from getting COVID-19. However, there’s no evidence that this is true.

Neither is there any scientific evidence to show that those who regularly take lopinavir, ritonavir, or other drugs in the protease inhibitor family have special resistance to the coronavirus. Starting or changing treatment based on such false information not only fails to prevent coronavirus infection but can also be counterproductive in the management of HIV.

Scientists advise not to take higher doses of drugs than what doctors have recommended. People with HIV should follow only the treatment they have taken so far, and follow the same step-by-step recommendations that we should all follow.

What should people with HIV do during the coronavirus pandemic?

Ultimately, the recommendations for people with HIV during the coronavirus pandemic are to isolate themselves, practice good hygiene, and maintain the antiretroviral treatment they were already receiving. They should ensure that they have a good supply of the drugs, as we do not know when the restrictive measures will end. Finally, if they have any questions, then they should consult their doctor.

  • Valdes, M. Á. S. (2020). Infección respiratoria aguda por 2019-nCoV: una amenaza evidente. Revista Habanera de Ciencias Médicas, 19(1), 1-5.
  • Guo, Wei, et al. “A Survey for COVID-19 Among HIV/AIDS Patients in Two Districts of Wuhan, China.” AIDS Patients in Two Districts of Wuhan, China (3/4/2020) (2020).
  • Remor, Eduardo. “Valoración de la adhesión al tratamiento antirretroviral en pacientes VIH+.” Psicothema 14.2 (2002): 262-267.
  • Ayouba, Ahidjo, and Martine Peeters. “Reply to Zhang et al.” The Journal of Infectious Diseases (2020).
  • Chakraborty, Sandeep, and Gautam Das. “Why re-purposing HIV drugs Lopinavir/ritonavir to inhibit the SARS-Cov2 protease probably wont work-but re-purposing Ribavirin might since it has a very similar binding site within the RNA-polymerase.” OSF Preprints. March 22 (2020).