COVID-19 Infection Linked to Detectable Viral Levels in HIV Patients on ART

By Reuters Staff

December 03, 2020

NEW YORK (Reuters Heath) - People with HIV who have recovered from COVID-19 infection are more likely to have detectable levels of HIV-1 RNA in their plasma than individuals with HIV but no SARS-CoV-2 co-infection, according to new research.

Highly sensitive single-copy assays found HIV-1 RNA in plasma from 83% of 12 HIV patients on antiretroviral therapy (ART), compared to 59% of HIV patients on ART tested before the pandemic, Dr. Timothy J. Henrich of the University of California, San Francisco, and colleagues found.

"Although sample sizes were modest and there were no significant differences between COVID-19+ and pre-COVID-19 groups, the above results suggest that lasting perturbations of immune function and systemic inflammation may impact the natural course of HIV infection, potentially months following HIV infection," they write in Clinical Infectious Diseases.

Studies of HIV seropositivity and acute SARS-CoV-2 infection have had mixed results, with one study finding higher 28-day mortality in people with HIV, but others finding no differences in COVID-19 severity or mortality, Dr. Henrich and his team state.

To investigate whether co-infection with SARS-CoV-2 and HIV might lead to increases in HIV-1 RNA, the authors looked at 12 HIV patients on ART a median of 37 days after their COVID-19 symptoms appeared, and 17 patients on ART who underwent plasma collection between March 2018 and October 2019.

Ten people in each group had detectable plasma HIV-1 RNA. Median HIV-1 RNA copies per milliliter were 1.59 for the COVID-19 group versus 0.38 for the pre-COVID patients.

Four of the patients in the COVID-19 group who had detectable viral levels were tested again a median of 75 days after their symptoms began, and three still had detectable HIV-1 plasma RNA (median, 1.95 copies/mL).

"Whereas these low-level viremic episodes are unlikely to have direct clinical implications for patients, larger, prospective studies will be needed in order to fully understand the long-term impact of COVID-19 on HIV dynamics and viral immune responses," Dr. Henrich and his team conclude.

Dr. Henrich was not available for an interview by press time.

SOURCE: Clinical Infectious Diseases, online November 21, 2020.