HIV and COVID-19: review of clinical course and outcomes

Background:Understanding the relationship between HIV and SARS-CoV-2 has important public health implications. Objective:To summarize current research on COVID-19 among people with HIV (PWH) as published through 15 July 2021. Methods: We conducted a search of PubMed, Scopus, preprint databases (medRxiv, bioRxiv), and the references of publications found using key terms relevant to COVID-19 (‘COVID-19’ OR ‘SARS-CoV-2’ OR ‘coronavirus’) AND to HIV (‘HIV’ OR ‘Human Immunodeficiency Virus’ OR ‘AIDS’ OR ‘Acquired Immunodeficiency Syndrome’). We summarized all articles that reported data or opinions on SARS-CoV-2 and HIV coinfection. Conclusions: Although many initial case series and cohort studies found no increased risk for SARS-CoV-2 infection or severe COVID-19 outcomes among PWH, recent studies have signaled an increased risk for severe COVID-19 disease progression even in the setting of well-controlled HIV. Whether this is due to the increased prevalence of comorbidities in PWH and other social determinants of health is unknown. These conflicting findings highlight the continued need for COVID-19 related research among PWH that addresses COVID-19 disease course as well as exacerbation of existing comorbidities already disproportionately represented among PWH.