Infectious Disease

Individuals dwelling with HIV needs to be prioritized for COVID-19 vaccination

March 03, 2021

2 min read

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Disclosure:
DeHovitz reports that he has received funding from the NIH for HIV research.

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The NIH said people living with HIV should be considered a high risk group when making decisions about the priority of the COVID-19 vaccine. The recommendation was part of the NIH’s updated preliminary guidelines for COVID-19 and HIV.

Previous research has shown that HIV increases the risk of death or worse outcomes from COVID-19, while other studies have indicated that HIV does not affect outcomes or the risk of hospitalization from COVID-19.

NIH HIV Update Infographic

Source: HIV.gov. Guide for COVID-19 and people living with HIV. https://clinicalinfo.hiv.gov/en/guidelines/covid-19-and-persons-hiv-interim-guidance/interim-guidance-covid-19-and-persons-hiv/. Accessed February 2, 2021.

To address these concerns, doctors previously set up the CURE (Coronavirus Under Research Exclusion) registry for doctors – a database of information on COVID-19 cases in HIV patients.

“As we get more data from certain chart studies, and even from prospective studies of people with HIV, we will begin to identify the absolute risk much more clearly.” Jack A. FromH.ovitz, MD, MPH, MHCDS, FACP, Healio said, a distinguished service professor and director of the HIV Center for Women and Children at Downstate Health Sciences University, State University in New York.

“The existing administrative data studies and observational studies certainly suggest that morbidity and mortality may be higher in people with HIV,” said DeHovitz.

For all people living with HIV, the NIH recommends:

  • The CDC’s SARS-CoV-2 prevention measures, such as social distancing and wearing masks, are followed.
  • You will receive SARS-CoV-2 vaccines regardless of CD4 count or viral load.
  • Pregnant or breastfeeding women who meet the criteria for vaccination should not be excluded from access to vaccines.
  • The vaccination against pneumococci and influenza must be kept up to date. The COVID-19 vaccine should not be given within 2 weeks of another vaccine.
  • Overall, people living with COVID-19 with HIV should receive the same clinical management and medical triage care as the general population.

For the treatment of COVID-19 in HIV patients, the NIH recommends:

  • the same considerations as the general population for triage, management, and treatment for COVID-19;
  • HIV-associated opportunistic infections should be weighed during the diagnosis of febrile illness in people with advanced HIV.
  • Physicians should look out for drug interactions and overlapping toxicities with COVID-19 treatments, antiretroviral drugs, antimicrobial therapies, and other medications
  • People with HIV should be offered the opportunity to participate in clinical vaccine studies or potential treatment studies for SARS-CoV-2.

DeHovitz said it was important that doctors be aware of new HIV and COVID-19 research and “educate their patients and encourage them to get vaccinated”.

References:

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Gitanjali Pai, MD)

Gitanjali Pai, MD

This is certainly a welcome update on COVID-19 vaccines in our vulnerable HIV population. Traditionally, the immunodeficient HIV population has been largely excluded from clinical trials, including vaccine studies. Ironically, this is precisely the population we need to protect, among other things, especially in relation to their impaired immune system. Studies examining the COVID-19 vaccines have included people with HIV, but these are relatively low in numbers and longer in follow-up, and more data is expected. However, since the vaccines currently available are not live virus vaccines, this appears to be less relevant to safety for HIV patients. Despite the possibility of a weaker immune response to the vaccine, any protection vaccine administration offers during this pandemic would be a win – with the potential benefits outweighing the potential risks. I welcome this much-needed and encouraging guidance advocating our HIV patient population.

Gitanjali Pai, MD

Infectious Disease News Editorial Board Member

Infectious Disease Doctor

Memorial hospital and medical clinic

Stilwell, Oklahoma

Disclosure: Pai does not report any relevant financial information.

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