Is Covid-19 more dangerous to HIV+ people?

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PULSE Clinic

PULSE Clinic

Established in Bangkok, PULSE Clinic is a gay-owned private clinic whose mission is to promote and provide excellence in standards of care and education in sexual wellbeing, HIV and related infections, and to actively engage in the formulation of public health policy and research, with the aim of reducing HIV disease burden worldwide.


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If you are or know someone living with HIV, you may have questions about whether the COVID-19 poses any additional medical threat. We break it down for you here:

Q: What is COVID-19?

A: COVID-19 is the infectious disease caused by the most recently discovered coronavirus. Coronaviruses are a large family of viruses which may cause illness in animals or humans.  In humans, several coronaviruses are known to cause respiratory infections ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS).

People can catch COVID-19 from others who have the virus. The disease can spread from person to person through small droplets from the nose or mouth which are spread when a person with COVID-19 coughs or exhales. These droplets land on objects and surfaces around the person. Other people then catch COVID-19 by touching these objects or surfaces, then touching their eyes, nose or mouth. People can also catch COVID-19 if they breathe in droplets from a person with COVID-19 who coughs out or exhales droplets. This is why it is important to stay more than 1 metre (3 feet) away from a person who is sick.

Q: Is COVID-19 dangerous to people living with HIV?

A: Current clinical data suggest the main mortality risk factors of COVID-19 are linked to older age and other comorbidities including cardiovascular disease, diabetes, chronic respiratory disease, and hypertension.

People living with HIV (PLHIV) who have not started treatment or not achieved viral suppression (undetectable viral load) through anti-retroviral treatment may have a compromised immune system that leaves them vulnerable to infections and further disease progression. 

So, if you know you are HIV positive and haven’t started the treatment, talk to your doctor to start the treatment and suppress the virus until you reach undetectable viral load and remain undetectable. 

PLHIV are advised to take the same precautions as other population (e.g. wash hands often, cough hygiene, avoid touching your face, physical distancing, seek medical care if symptomatic, self-isolation if in contact with someone with COVID-19 and other actions per the government response).  

Q: What about COVID-19 and HIV+ people with an undetectable viral load?

A: At present there is no evidence to suggest that there is an increased risk of infection and increased severity of illness for PLHIV and there is currently no reported case of COVID-19 infection among PLHIV, though this can rapidly change as the virus spreads. 

PLHIV who are taking ARV drugs should ensure that they have at least 30 days of ARVs if not a 3 to 6-month supply and ensure that their vaccinations are up to date (influenza and pneumococcal vaccines).

Q: Can PrEP prevent COVID-19?

A: No. There is no evidence to support the idea of HIV-negative people taking anti-retrovirals to prevent anything else. PrEP is proved and recommended to prevent you from HIV infection – PrEP should be taken as directed and there is no current evidence that PrEP is effective against COVID-19.

Q: Can I take other HIV drugs to prevent COVID-19?

A: No. There is ongoing discussion and research around some HIV anti-retrovirals which may have some activity against COVID-19. The first randomised clinical trial with lopinavir/ritonavir demonstrated no benefit over standard care in 199 hospitalised adults with severe COVID-19.