T
he novel coronavirus (SARS CoV-2), which causes COVID-19, infects every one, including persons who have HIV and other viral infections such as Hepatitis B and Hepatitis C. Today, we have effective antiretroviral therapy (ART) to suppress HIV and thereby persons who are on ART, don’t fall sick and live normally without any symptoms. Research has shown their life span is similar to those who don’t have HIV.
Does COVID19 cause worsening of HIV disease and vice versa?
Persons who are on regular anti-retroviral therapy and adhere to these medications have undetectable HIV levels and normal immunity, as measured by CD4 cell count. COVID-19 can cause similar mild symptoms like any other normal individuals among persons with HIV and on antiretroviral therapy. Hence, all those who have HIV should adhere to their antiretroviral therapy. This will save them. If they are not taking ART and if the immunity is low as measured by CD4 cell count, then COVID-19 can cause severe serious illness in these individuals. Persons with HIV and on ART can have other co-morbid non-communicable diseases such as diabetes, hypertension, cancers and renal disease. These individuals should make sure their co-morbid conditions are managed effectively. They should control their underlying conditions. If they don’t do this, COVID-19 can cause severe illness. Take your medicines for diabetes, hypertension, cancer and kidney disease if you have, along with your ART and exercise.
Will TB patients who get COVID-19 suffer more?
Tuberculosis affects the lungs and other organs, and COVID-19 causes severe lung infection. Persons who have tuberculosis and are not taking their TB medicines can develop severe respiratory diseases if they are infected with COVID-19. Make sure to take your medicines for tuberculosis regularly so that it won’t cause severe illness even if you do acquire an infection.
What about other chronic viral diseases?
Today, we have anti-viral medicines for Hepatitis B and Hepatitis C, which cause jaundice, liver cirrhosis and liver cancer. The treatment for Hepatitis B is lifelong and Hepatitis C is curable with three months of antiviral therapy. Not managing these viral hepatitis conditions can cause severe liver disease if these people acquire COVID-19. Vaccines are available for Hepatitis B prevention. Do vaccinate yourself if you haven’t done it yet.
Do we have treatment for COVID-19 and do they have side effects with HIV antiretroviral and other antiviral medications?
At present, there is no specific antiviral treatment for COVID-19. We offer only supportive care. These medications used for supportive care are provided under supervision by trained medical doctors and side-effects are closely monitored. Research on the natural history of COVID-19 shows this novel coronavirus gets suppressed on its own within 14-28 days in most individuals who acquire the virus. There are several antiviral medications under clinical trials for COVID-19. One such drug called Remdesivir is under advanced Phase 3 clinical trials. Remdesivir inhibited SARS-CoV-2 replication in laboratory studies and was tested in a few patients with COVID-19 in the Unites States. The patients’ symptoms improved following intravenous Remdesivir administration. However, more clinical data is required before the drug can be approved for use. We expect early results of this drug effect on COVID-19 by this month-end. Let us hope we researchers and healthcare workers will conquer COVID-19 like HIV and Viral Hepatitis as we did in the past!
Feel free to write to kumarasamy@cartcrs.org if you have more questions on treatment for COVID19.
