COVID-19 Outcomes No Worse for Those Living with HIV

  • New research out of Mount Sinai further confirms that the presence of HIV does not post a greater threat for worse COVID-19 outcomes.
  • It was the largest study of a group of people who were both living with HIV and hospitalized with COVID-19.
  • Compared to sample groups of people who are HIV-negative, the outcomes were about the same.
  • Experts say this should ease fears some people with HIV might have about increased risk for COVID-19.
  • They also stress that everyone should adopt preventive measures such as wearing a mask, practicing physical distancing, and washing their hands often.

New research out of Mount Sinai has further confirmed that people living with HIV who also test positive for COVID-19 are at no greater risk for worse outcomes from the coronavirus than other populations.

In the early days of COVID-19 when not much was known about the virus, some misinformation spread about how it might be impacting people with different chronic conditions, including HIV.

This new research should put people living with HIV somewhat at ease during an uncertain time.

While they should take the same preventive precautions — from wearing masks to physical distancing — to stay safe during the current health crisis, they don’t stand at elevated risk.

The new findings

The study, published in the journal Clinical Infectious Diseases, surveyed the largest and most diverse group of people living with HIV who have tested positive for COVID-19 so far.

The researchers examined 88 people living with HIV who were hospitalized with confirmed COVID-19 from March 12 to April 23.

While poor COVID-19 outcomes did occur for some people who were hospitalized — for instance, 18 percent needed to be put on ventilation and 21 percent died during a follow-up period — these outcomes were no different than the general population at large.

“We came at this really not knowing what to expect because although people with HIV nowadays — the vast majority have very well-controlled HIV with probably very close to ‘normal immune function’ — we do find many people with well-controlled HIV still have immune abnormalities,” said lead researcher Dr. Keith Sigel, associate professor of medicine at the Icahn School of Medicine at Mount Sinai.

He said he and his team weren’t sure how these “immune abnormalities” might impact a person’s outcomes with COVID-19.

Generally speaking, he said people living with HIV tend to be “sicker” — higher instances of stroke, for instance — which would lead you to think COVID-19 might prove more dangerous for them.

When compared to groups of people who matched these individuals by age, sex, race, and ethnicity, the outcomes were very similar.

Given that Mount Sinai’s New York-based hospital system is one of the largest healthcare providers of people living with HIV in the country, and they weren’t already seeing a high number of people from this population hospitalized for COVID-19, Sigel said the study results weren’t a total shock.

“If anything, this is information that I’m using when I talk to my patients,” Sigel said. “I’m telling them ‘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.'”

This research contributes to the growing understanding that HIV doesn’t pose a significant risk for the new coronavirus.

Earlier this year, the Centers for Disease Control and Prevention (CDC) asserted that there’s no scientific evidence that links HIV as an increased COVID-19 risk factor.

“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,” Sigel added.

Implications of this research

Dr. Alan Taege, an infectious disease expert at Cleveland Clinic, echoed Sigel that these findings help give HIV clinicians and researchers a clearer way to assert to people living with HIV that they shouldn’t have extra fears during this difficult time.

One interesting question this research poses is: Why doesn’t HIV lead to increased risk compared to other chronic conditions?

“I don’t believe we have a clear explanation at this time as to why HIV patients appear to have very similar outcomes as the matched general population. We had all feared the worst,” Taege, who wasn’t affiliated with this research, told Healthline.

“There was some early hope there may be a protective effect of some of the HIV treatment medications but this has not been clearly demonstrated,” he added.

Earlier this year, news broke that clinical trials were being held to determine if antiretroviral therapies (ART) for HIV could be used for COVID-19, but they haven’t yielded clear results yet.

One thing this does underscore is that, thanks to advancements in HIV therapies, people living with HIV today have a level of health that’s no different than the population at large.

In fact, if a person adheres to their medication regimen, they can achieve an “undetectable” viral load. This just means that person can’t transmit HIV to HIV-negative sexual partners, according to the CDC.

Looking ahead

Sigel said that, of course, COVID-19 should be a serious concern for all people, including those living with HIV.

Moving forward, what’s next?

“One very interesting piece is if people with HIV are not having severe outcomes, is there something that is protecting them?” Sigel said. “We did have a finding that being on [a] certain class of antiretrovirals, the non-nucleoside reverse transcriptase inhibitors, seems to be protective against death. A study out of Spain has similar findings.”

Like Taege, he said that he would be interested in exploring this further to see if HIV medications could hold the key to offering some sort of COVID-19 protection.

“HIV patients should continue to take all the same precautions as other people — wear masks, avoid crowds, physical distance, and do frequent hand washing/sanitizing,” Taege said, when asked what he would like to say to people living with HIV. “Be careful, be smart, and be safe.”

The bottom line

New research out of Mount Sinai further confirms that the presence of HIV doesn’t pose a greater threat for worse COVID-19 outcomes.

It was the largest study of a group of people who were both living with HIV and hospitalized with COVID-19. Compared to sample groups of people who are HIV-negative, the outcomes were about the same.

Experts say this should ease fears some people with HIV might have about increased risk for COVID-19. That being said, everyone should adopt preventive measures such as wearing a mask, practicing physical distancing, and washing their hands often.


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