Virologic and Immunologic Outcomes for HIV Patients With Coronavirus Disease 2019

Rong Hu, MPH; Han Yan, MPH; Manqing Liu, MSc; Li Tang, MPH; Wenhua Kong, MSc; Zerong Zhu, MSc; Pan Liu, MSc; Wenjuan Bai, MPH; Xuejiao Hu, MPH; Jie Ding, BD; Xia Wang, MPH; Nianhua Xie, MPH


J Acquir Immune Defic Syndr. 2021;86(2):213-218. 

In This Article

Abstract and Introduction


Background: To describe the virologic and immunologic outcomes among people living with HIV (PLHIV) coinfected with SARS-CoV-2.

Setting: Wuhan, China.

Methods: Thirty-five coinfected patients were identified by matching the reported cases in National Notifiable Infectious Disease Report system for COVID-19 and HIV in Wuhan by time of April 19, 2020. Questionnaire-based survey and follow-up with blood sample collection were used to obtain characteristics before COVID-19 and after recovery. Nonparametric Mann–Whitney U test, χ 2, or Fisher exact test, Mcnemar test, and Wilcoxon test were conducted.

Results: Twenty of the 35 coinfected patients were identified as asymptomatic/mild/moderate COVID-19 (nonsevere group) and 15 were identified as severe/critical (severe group). The severe and nonsevere group had no differences in demographics, HIV baseline status, the intervals between last tests and follow-up tests for CD4+ cell count and HIV-1 viral load (all P > 0.05). Overall, there was a significantly increased number of coinfected patients with HIV-1 viral load ≥20 copies/mL after recovery (P = 0.008). The median viral load increased significantly after recovery in severe group (P = 0.034), whereas no significant change of HIV-1 viral load was observed in the nonsevere group. Limited change of CD4+ cell count was found (all P > 0.05).

Conclusion: The coinfection of SARS-CoV-2 may put PLHIV at greater risk for HIV-1 viral rebound especially for severe/critical COVID-19, whereas it had limited impacts on CD4+ cell count. Whether continuous antiretroviral therapy against HIV infection would have significant impacts on CD4+ cell count among PLHIV coinfected with SARS-CoV-2 needs further research.


In late December, the coronavirus disease 2019 (COVID-19) caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first reported in Wuhan, China. It has quickly spread across China and throughout the world, bringing serious threat to public health. Several comorbidities such as diabetes and hypertension have been identified as risk factors of critical and mortal COVID-19 cases,[1] but data on people living with HIV (PLHIV) coinfected with SARS-CoV-2 are scarce. Limited literature mainly focused on the description of clinical characteristic of the COVID-19 and/or the effect of HIV infection on the prognosis of COVID-19.[2–5] Whether PLHIV coinfected with SARS-CoV-2 would aggravate HIV infection remains unknown.

Here, we would like to describe the HIV progression as measured by viral load and CD4+ cell count before COVID-19 and after recovery, and potential toxic side effects as measured by biomedical data such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), and serum creatinine etc. in the setting of SARS-CoV-2 infection among PLHIV.