Entirely separate from the potential role of HIV itself as a risk factor for severe COVID-19 disease, the coronavirus pandemic appears to have indirectly increased the risk for HIV-related morbidity, British researchers argued in Clinical Infectious Diseases.
The researchers explored hospitalizations of PLWH at Chelsea and Westminster Hospital in London, United Kingdom, between July and October 2020 compared to the same period in 2019. Fewer PLWH were admitted to the hospital in 2020 than in 2019 (48 vs. 80 people), but those admitted in the COVID-19 era tended to present with more advanced HIV disease, and a greater number were newly diagnosed with HIV.
Specifically, among PLWH, 54% of 2020 hospitalizations were for an AIDS-defining illness, compared to 27% in 2019. (Despite the lower overall number of hospitalizations among PLWH in 2020, the actual number of people presenting with an AIDS-defining illness rose, from 21 to 26.)
Similarly, the median CD4 count was lower (63 in 2020 vs. 157 in 2019) and median viral load was significantly higher (123,000 vs. 115 copies/mL) during the pandemic. In addition, 17% of PLWH in-patients were newly diagnosed with HIV in the 2020 period versus 6% in 2019 (another case in which the actual number of people impacted increased, from five newly diagnosed patients to eight).
These differences are likely due to lockdown-related issues with access to health care or HIV testing and/or reluctance entering health care during the first wave of COVID-19 in the UK, study authors suggested, concluding: “When addressing the consequences of this pandemic on PLWH, it is important to consider the additional repercussions in accessing HIV testing and HIV diagnosis, and linkage to care, ultimately translating into increased morbidity for PLWH.”