Corona: Are patients living with HIV at higher risk of infection?

The change that has taken place in knowledge about AIDS and the treatment of people living with HIV since the 1980s to the present day is a 180-degree change. An infectious virus that was considered in those days a dangerous epidemic and causes a fatal disease and mortality on a significant scale, today it is a virus that can be lived with as much as any human and in good health, a virus that with proper treatment can not even be transmitted.

The complex “cocktail” that sometimes included 16-18 pills a day that patients were required to take over the years, is now replaced by a simple and very easy treatment to take, usually one pill a day, that allows HIV-living patients to live a good quality of life and minimize the virus itself. This is exactly why the term “HIV-positive” is disappearing from the world and instead I use the term “living with HIV”.

But what about the current plague that is befalling us in this period? The corona virus puts many groups in the population at risk. If so, how does the corona, if any, affect life with HIV and is this population at all more susceptible to the virus? The answer is yes and no. On the one hand, HIV does not pose a high risk of coronary heart disease or its complications. On the other hand, for many HIV has been a accelerating factor in the development of background diseases, such as diabetes and unbalanced blood pressure. The reasons for this vary and stem from a combination of life in the shadow of the virus and the various drugs given in the past and given even today.

When a patient lives with HIV and is required to take multiple medications daily for many years, it affects different systems in the body and this effect can manifest itself in various problems and increase the risk of ischemic heart disease, vascular disease, various metabolic diseases and so on. These diseases are certainly a risk factor during this period, a risk that in the case of infection with the corona virus may manifest itself in severe complications and a higher risk of a serious illness.

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Therefore, strict adherence to the treatment and monitoring of the various indices of background diseases, which is very important for living with HIV even in normal days, is all the more important during the time of an epidemic such as the corona plague. On the one hand, patients must take care of their health alongside HIV and ensure that diabetes, blood pressure and the various indices are balanced, and on the other hand, patients must ensure that their HIV medication is taken regularly in order to stay in a state where the virus is not measurable in their blood.

Corona test (Photo: Yossi Aloni, Flash 90)

Over the years, as treatment progressed, the therapeutic load decreased and today there are new and effective drugs that help life with HIV reach normal levels of good CD4 cells. These cells are part of the white blood cells that fight various infections in the body. These treatments make it possible to reach a state called undetectable, and in this state they are not contagious at all.

Not only that, if in recent years HIV treatments have included three medications that patients were required to take daily that could lead to a therapeutic load, new studies have shown that a drug combination of only two drugs is as effective as giving three drugs. This important trend actually proceeds from the premise that it is better for the patient to take, if possible, as few medications as possible in order to achieve a similar result. Following these findings recently, a drug called Dubato has been registered in Israel for patients living with HIV and contains only two drugs.

As treatment progresses, the emphasis in recent years has shifted to maintaining a better quality of life. This is similar to treating chronic diseases with the emphasis on maintaining overall health. The role of GPs during this period has become no less important than that of infectious disease physicians in balancing and preventing background diseases and requires optimal collaboration between physicians, whether in better follow-up or prevention of further morbidity by vaccines and screening tests. A relevant example for this period is flu vaccines and pneumonia for the winter. Maintaining a healthy lifestyle is also very important, whether it is in proper nutrition, exercise and so on.

Maintaining a healthy lifestyle, proper follow-up, prevention and treatment of background diseases and effective treatment for HIV, all of these allow patients living with him a better opportunity to enjoy a good quality of life and prolong life as much as the person.

The author is an infectious disease specialist at Mount Sinai Hospital, New York, an associate physician at the Gan Meir Clinic and an infectious disease consultant from the Tel Aviv District at Clalit Health Fund.