South African researchers have identified HIV, regardless of whether it is fully suppressed with antiretrovirals, as a factor that increases the risk of dying following a COVID-19 diagnosis, aidsmap reports.
This finding is notable because most studies, including those conducted in Europe and the United States, have not found that people with HIV are more likely to acquire the new coronavirus, develop severe COVID-19 or die from it.
Researchers analyzed public health data from South Africa’s Western Cape Department of Health, which has access to data from all public sector health facilities. They presented their findings during a webinar on COVID-19, HIV and tuberculosis that was hosted by Bhekisisa.org and the Aurum Institute.
The investigators pored over data regarding 3.5 million adults receiving public sector health care in the Western Cape province, including 12,987 people who were diagnosed with COVID-19. Four hundred thirty-five of them have died.
After controlling the data to account for various differences among the cohort members, the researchers found that among people diagnosed with COVID-19, having HIV was associated with a 2.75-fold increase in the risk of dying from COVID-19. This finding held regardless of whether the people with HIV had a fully suppressed viral load.
The investigators found that the death rate of the people with HIV who died of COVID-19 was 2.33-fold higher than would normally be expected given their age and sex composition.
The researchers noted that almost all those with HIV who died of COVID-19 had other health conditions. About half had diabetes, and approximately half had high blood pressure—both of which are factors associated with an increased risk of death from COVID-19. The data suggest that the HIV-positive people who died of COVID-19 did not have advanced HIV disease. Rather, thanks to treatment for that virus, they had lived long enough to develop those other health conditions (which are themselves associated with even well-treated HIV).
The analysis found that in the cohort of people with COVID-19 as a whole, diabetes—in particular, uncontrolled diabetes—was associated with an even higher risk of death from COVID-19 compared with HIV. Diabetes was associated with a 4.65-fold increased risk of death from COVID-19, poorly controlled diabetes was associated with an 8.99-fold increased risk of death, and uncontrolled diabetes was associated with a 13.02-fold increased risk of death.
To read the aidsmap article, click here.
To watch the webinar, click here.