According to the analysis done by the National Institute for Communicable Diseases (NICD) in the Western Cape, people who are HIV-positive might still be at risk of dying from Covid-19, when compared to those who are HIV-negative.
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However, they are less likely to die from the coronavirus than those with other underlying illnesses, such as diabetes and high blood pressure. NICD stated that people living with HIV are at “modestly” increased risk of dying from Covid-19, whether the virus is suppressed or not.
These findings are based on data collected from adult patients attending public sector health facilities in the Western Cape between 1 March 1 and 4 June to help identify factors associated with Covid-19 death, including HIV.
The NICD revealed that less than 10% of all Covid-19 deaths in the province were attributable to HIV. Older age, male sex, diabetes mellitus, current and previous tuberculosis, chronic kidney disease and other comorbidities were also associated with increased Covid-19 mortality.
“The Western Cape, with a population of about 7 million, has 520 000 HIV-positive people. More than 90% of these people depend on public sector health services,” the NICD says.
“Of the surviving and deceased Covid-19 [patients], HIV-positive people, 69% and 66% respectively, were considered ‘well on antiretroviral treatment [ART]’.”
The study also found that Covid-19 death was associated males, increasing age and diabetes mellitus (with higher risk for those with elevated HbA1c), hypertension and chronic kidney disease, as well as previous and current tuberculosis.
“After adjusting these factors, there was an increased hazard of Covid-19 death in people living with HIV compared to HIV-negative patients.
“The increased mortality risk was similar in people living with HIV who were 'well on ART' as compared to those who previously started ART but without documented recent viral suppression, or those who had never started ART.”
It also found that among all public and private sector laboratory-diagnosed Covid-19 cases, there were 97 deaths among an estimated 520 000 HIV-positive people in the province.
“We found approximately twice the risk of Covid-19 deaths in people with HIV, irrespective of viral suppression, or ART use. This increased risk is modest in comparison to the increased risk of Covid-19 death associated with other risk factors such as older age or diabetes.
“Nonetheless, despite a high burden of HIV in the province (16%) and inactive public sector patients, we have not seen large numbers of patients with advanced HIV and severe Covid-19, and the attributable fraction of all deaths ascribed to HIV is less than 10%,” the NICD says.