HIV-positive patients who take ARVs 'not at greater risk of contracting Covid-19'

South Africans who are HIV-positive and take antiretrovirals are not at greater risk of contracting Covid-19, a local expert said on Thursday.

The revelation comes after experts around the world expressed concern about the  effect of the pandemic on SA, which has the most people afflicted with HIV of any country.

However, clinician Dr Kairoonisha Mahomed, who runs an HIV clinic in Johannesburg, says that HIV-positive individuals who remain on treatment and whose viral loads are at undetectable levels are likely to be at no greater risk of contracting Covid-19.

“The treatment and management of HIV has improved in leaps and bounds in recent years, to such an extent that it has become a highly manageable chronic condition. And, while there is much that we are still learning about the Covid-19 virus, there is no reason to believe that a properly managed HIV-positive individual whose viral load is suppressed is at any greater risk from Covid-19 than the rest of the population,” said Mahomet.

But Mahomet, who has been treating patients and training doctors and nurses in HIV care for the past 10 years, said people who defaulted on treatment remained at risk.

“On the other hand, HIV-positive individuals who are not receiving treatment, or who have stopped taking their antiretroviral medicines during the lockdown, are likely to be at a greater risk of contracting serious Covid-19 infection, or of developing other HIV-associated conditions such as tuberculosis,” she said.

TimesLIVE earlier reported that 11,000 HIV-positive patients had defaulted on treatment since the start of the lockdown. Mahomet said this was deeply concerning.

“It is imperative for all HIV-positive individuals to continue to take their antiretroviral medication, even if queues for medication may be longer than usual. If patients have missed taking either or both their HIV and TB medication they should urgently visit their health-care provider so that their condition can be monitored and treated,” he said.

However, HIV/Aids activist organisation Treatment Action Campaign (TAC) said people with HIV feared exposing themselves to Covid-19 which had broken out in a number of health care facilities.

Secretary-general Anele Yawa said the organisation had been calling on the state to provide treatment for three to six months to avoid monthly visits.

“We’re calling on our government to speed up the process of rolling out a four to six months' treatment refill, meaning that if you are living with HIV, TB and other chronic illness, instead of going month to month, so that they don’t end up exposing themselves ... ” he said.

Yawa said about 2-million HIV-positive people were not taking their medication, meaning their health was “heavily compromised” and that they were not immune to contracting other diseases like TB and Covid-19.

Mahomet said there had been cases where HIV-positive individuals had stopped their ARV treatment and as a result developed TB, resulting in them to being  admitted to hospital.

“Many South Africans are not aware that highly effective new antiretroviral drugs, which have virtually no side effects in most people and which can be taken as just a single dose in the morning, have been introduced in recent years. These new ARVs are not only easy for people to tolerate, but are highly effective in suppressing viral loads to undetectable levels, which means that their immune systems are kept strong,” she said.

Mahomet said internationally, there had been little research about experiences of HIV-positive individuals with Covid-19. Given the large numbers of HIV-positive people in SA, however, she said clinicians were likely to learn much about these two diseases and how they affect on one another.

“HIV patients are now living to a ripe old age and hence chronic care should now also form an important part of their HIV care.

She urged those who are not on treatment to do so urgently to safeguard their health.  

“It is my hope that the Covid-19 pandemic may at least have the benefit of getting more South Africans to seek treatment with these new ARVs because they are so effective and are giving many people a completely new lease on life,” added Mahomet.