Adults with advanced HIV should be prioritised for Covid-19 vaccine- SA study

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 Covid-19 vaccine.

The article was published on the Kwazulu-Natal Research Innovation and Sequencing Platform (KRISP) website on Thursday.

Professor at the Africa Health Research Institute (AHRI), Alex Sigal, said the study aimed to understand the effects of HIV infection and 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 has been uncontrolled and where antiretrovirals were not taken properly, the body’s T-cells begin to deplete. These cells are a very 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 that there has been evidence showing that HIV is 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 antiretroviral 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 the University of KwaZulu-Natal, 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 216 days, or over 6 months.

“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,” he said.