The World Health Organization has issued questions and answers on COVID-19 for the HIV community (17 March 2020).
Are people living with HIV (PLHIV) at an increased risk of being infected with COVID-19?
- There is currently no evidence suggesting an increased risk of infection or increased severity of illness among PLHIV. The advice is to follow the same precautions as the general population.
- The main mortality risk factors are linked to older age and other comorbidities including; cardiovascular disease, diabetes, chronic respiratory disease, and hypertension.
Can antiretrovirals be used to prevent or treat COVID-19?
- Some evidence from previous SARS and MERS outbreaks show lower infection rates following post-exposure prophylaxis treatment with lopinavir boosted with ritonavir (LPV/r).
- Some studies have suggested that the treatment of COVID-19 with LPV/r had good clinical outcomes.
- All studies were small and had many limitations.
If antiretrovirals are used to treat COVID-19, are there concerns about treatment shortages for PLHIV?
- A relatively small proportion of PLHIV are on regimens which include LPV/r, as it is used as a second-line regimen according to WHO’s HIV treatment guidelines.
- Ensure that PLHIV have at least 30 days supply of antiretroviral treatment. For those not currently taking ART, this is a good time to start.
- Simplified antiretroviral therapy (ART) delivery models which include multi-month prescriptions (from 3-6 month supply) which reduce the frequency of visits to clinical settings and ensures continuity of treatment is recommended.
Human rights, stigma, and discrimination.
- WHO is working with partners including the UNAIDS Joint Programme and the Global Network of People Living with HIV to ensure that human rights are not eroded in the response to COVID-19 and to ensure that people living with or affected by HIV are offered the same access to services as others and to ensure HIV-related services continue without disruption.