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Coronavirus Explained: How COVID-19 Impacts People Living With HIV

A new WHO report released earlier in July confirmed that HIV infection is a significant independent risk factor for both severe or critical COVID-19 presentation at hospital admission and in-hospital mortality

Coronavirus Explained: How COVID-19 Impacts People Living With HIV
Highlights
  • Current WHO recommended COVID vaccines are safe for people living with HIV
  • All people living with HIV should be prioritized for early vaccination: WHO
  • On hospitalisation, PLHIV have a 30% increased risk of COVID death: WHO

New Delhi: “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. 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 official and other experts explain the link between COVID-19 and HIV.

Also Read: COVID-19 Pandemic’s Long-Term Impact Could Lead To More New HIV Infections, AIDS-Related Deaths: United Nations

COVID-19 And The Risk It Poses To People Living With HIV

A new WHO report released earlier in July confirmed that HIV infection is a significant independent risk factor for both severe or critical COVID-19 presentation at hospital admission and in-hospital mortality. Overall, nearly a quarter (23.1 per cent) of all people living with HIV who were hospitalised with COVID-19, died. The report is based on clinical surveillance data from 37 countries regarding the risk of poor COVID-19 outcomes in PLHIV admitted to the hospital for COVID-19.

Underlying conditions such as diabetes and hypertension are common among PLHIV. Among male PLHIV over the age of 65 years, diabetes and hypertension were associated with an increased risk of more severe and fatal COVID-19. These conditions are known to put people at increased risk of severe disease and death, stated WHO while sharing the findings of the report.

Also Read: Opinion: Fighting The Twin Epidemic Of HIV And COVID-19 – Securing Food And Nutritional Access

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 aging population.

Talking more about the high COVID risk among PLHIV, Dr Mala Kaneria, Consultant Department of Infectious Diseases, Jaslok Hospital, Mumbai, said,

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 the mortality. Also, the radiological appearance of many opportunistic infections in HIV, is mimicked by COVID, thus delaying the diagnosis of either infection.

Also Read: Global Eradication Of COVID-19 More Feasible Than For Polio: Analysis

To control HIV infection, a treatment called antiretroviral therapy (ART) that involves taking a combination of HIV medicines is recommended. However, during the COVID pandemic, a reduction in access to prevention and testing services for HIV was reported, said Dr Doherty and added,

These kinds of services are the ones that we need to restart and maintain so that all people living with HIV have access to the antiretrovirals they need, they find out if they are living with HIV and also now start to be prioritised and have access to COVID-19 vaccines.

Are COVID-19 Vaccines Safe For People Living With HIV?

According to WHO, many of the COVID-19 vaccines 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.

Also Read: WHO Calls For ‘Moratorium’ On COVID-19 Vaccine Boosters Until At Least September-End To Address Vaccination Disparity

The currently available vaccine products are not live vaccines, they include genetic material from SARS-CoV-2 which cannot replicate. 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, as that in the other individuals, as prevention of severe disease and potentially reduced transmission of the SARS-CoV-2, she said.

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 said that there are some concerns that some of the newer generation vaccines may not be as effective in those who have very low CD4 counts, people who are not on treatment or have immunosuppression.

Also Read: Explained: What Is A Breakthrough Infection And How To Prevent Catching COVID-19 After Getting Fully Vaccinated

But certainly, that data is not clear yet. And we have to follow this forward as we learn more about some of the clinical trials that are happening in South Africa for some of these newer generation vaccines. And we would be very encouraging of people living with HIV to access those vaccines and not to have any differentiation in terms of whether or not they have a low CD4, high CD4 or suppress viral load or not. All should be in line for vaccines, said Dr Doherty.

The WHO expert also informed that the organisation will be looking forward to knowing whether people living with HIV might need a booster shot in the future. But, right now, the aim is to get everyone vaccinated.

Also Read: Antibodies Against SARS-Cov-2 Remain Stable, Even Increase Seven Months After Infection: Study

NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (WaterSanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollutionwaste managementplastic banmanual scavenging and sanitation workers and menstrual hygiene

World

22,95,44,435Cases
19,20,52,504Active
3,27,83,741Recovered
47,08,190Deaths
Coronavirus has spread to 195 countries. The total confirmed cases worldwide are 22,95,44,435 and 47,08,190 have died; 19,20,52,504 are active cases and 3,27,83,741 have recovered as on September 22, 2021 at 3:49 am.

India

3,35,31,498 26,964Cases
3,01,9897,586Active
3,27,83,741 34,167Recovered
4,45,768 383Deaths
In India, there are 3,35,31,498 confirmed cases including 4,45,768 deaths. The number of active cases is 3,01,989 and 3,27,83,741 have recovered as on September 22, 2021 at 2:30 am.

State Details

State Cases Active Recovered Deaths
Maharashtra

65,27,629 3,131

44,269 960

63,44,744 4,021

1,38,616 70

Kerala

45,39,926 15,768

1,61,765 5,813

43,54,264 21,367

23,897 214

Karnataka

29,69,361 818

13,769 617

29,17,944 1,414

37,648 21

Tamil Nadu

26,48,688 1,647

16,993 9

25,96,316 1,619

35,379 19

Andhra Pradesh

20,40,708 1,179

13,905 483

20,12,714 1,651

14,089 11

Uttar Pradesh

17,09,693 13

194 0

16,86,612 13

22,887

West Bengal

15,62,710 537

7,741 69

15,36,291 592

18,678 14

Delhi

14,38,556 39

400 21

14,13,071 18

25,085

Odisha

10,21,216 462

4,844 103

10,08,226 560

8,146 5

Chhattisgarh

10,05,120 26

297 0

9,91,260 26

13,563

Rajasthan

9,54,275 12

99 8

9,45,222 4

8,954

Gujarat

8,25,751 14

133 0

8,15,536 14

10,082

Madhya Pradesh

7,92,410 8

90 6

7,81,803 14

10,517

Haryana

7,70,754 8

328 12

7,60,618 20

9,808

Bihar

7,25,907 6

60 9

7,16,188 15

9,659

Telangana

6,63,906 244

4,938 53

6,55,061 296

3,907 1

Punjab

6,01,359 36

304 3

5,84,554 37

16,501 2

Assam

5,98,864 441

5,081 97

5,87,970 338

5,813 6

Jharkhand

3,48,139 14

65 10

3,42,941 4

5,133

Uttarakhand

3,43,405 12

249 18

3,35,765 29

7,391 1

Jammu And Kashmir

3,28,214 145

1,450 11

3,22,345 154

4,419 2

Himachal Pradesh

2,17,403 263

1,715 99

2,12,033 162

3,655 2

Goa

1,75,690 107

886 76

1,71,507 29

3,297 2

Puducherry

1,25,618 101

922 55

1,22,864 46

1,832

Manipur

1,18,870 197

2,174 9

1,14,861 203

1,835 3

Tripura

83,956 51

353 7

82,794 44

809

Mizoram

82,815 1,355

15,363 223

67,184 1,127

268 5

Meghalaya

79,817 150

1,878 18

76,558 167

1,381 1

Chandigarh

65,195 7

44 3

64,333 4

818

Arunachal Pradesh

54,190 64

413 3

53,504 60

273 1

Sikkim

31,014 43

627 27

30,007 70

380

Nagaland

30,959 52

470 3

29,832 46

657 3

Ladakh

20,743 6

144 6

20,392

207

Dadra And Nagar Haveli

10,670

0 0

10,666

4

Lakshadweep

10,360 1

9 1

10,300

51

Andaman And Nicobar Islands

7,607 7

17 4

7,461 3

129

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