Episode #48 - HIV & COVID-19

5 August 2021 | Science conversation

Vismita Gupta-Smith

Hello and welcome to Science in 5. I am Vismita Gupta-Smith and these are WHO's conversations in science. We are talking to Dr. Meg Doherty today about COVID-19 and how it impacts people living with HIV. Welcome, Meg. Let's start Meg with COVID-19 and the risk that it poses to people living with HIV.

Dr Meg Doherty

Thank you for that really important question. We are becoming more aware and following the data and it's now very much confirmed that people living with HIV have an increased risk for severe disease from COVID as well as hospitalizations. And then once hospitalized, have a 30% increased risk of death. So this is quite an important new statistic that we are taking seriously at WHO, but also something that now helps countries and people around the world to think about prioritizing both testing and treatment and management of hypertension and diabetes among people living with HIV.

This is also really important because we know in the last couple of years, during the COVID pandemic, we have seen a reduction and access to prevention services, testing services for HIV. And these kinds of services are the ones that we need to restart and maintain so that all people living with HIV have access to the antiretrovirals they need, they find out if they're living with HIV and also now start to be prioritized and have access to COVID-19 vaccines.

Vismita Gupta-Smith

Meg, should people living with HIV be prioritised for vaccinations?

Dr Meg Doherty

Considering that people living with HIV have a 30% increased risk of death if they are hospitalized and that we know vaccination for COVID protects people from both having severe disease and hospitalization and death - absolutely. People living with HIV should be prioritised for early COVID vaccines. We at WHO have been looking at the vaccines to see if they're safe among people living with HIV. And all vaccines currently right now on the market can be used among people living with HIV and certainly should provide adequate protection.

There are many studies looking at whether people who have low immunity or people who have immunosuppression need to have another dose of vaccine. And those data are not yet clear. And we'll be looking forward to knowing whether people living with HIV might need a booster shot in the future. But what we know right now is most of the world, in the low and middle income countries, in Africa that has the highest burden of HIV they don't even have the first vaccine.

So certainly we urgently need to start vaccinating people around the world and putting people living with HIV right up there in the line of people who need vaccines, along with people with comorbidities, who are older, who are front line workers.

Vismita Gupta-Smith

Meg speak to us a little more about safety of the current batch of vaccines for people living with HIV.

Dr Meg Doherty

What we know so far for all the vaccines that are under emergency use right now around the world, they should all be safe in people living with HIV. None of them are using live attenuated vaccines approaches which have been contraindicated in the past for people living with HIV. All of these vaccines that are out there now should be efficacious. We want to ensure that people living with HIV are on treatment.

There are some concerns that people who are taking some of the newer generation vaccines, that it may not be as effective in those who have very low CD4 counts, people who are not on treatment or have immunosuppression. But certainly that data is not clear yet. And we have to follow this forward as we learn more about some of the clinical trials that are happening in South Africa for some of these newer generation vaccines. And we would be very encouraging of people living with HIV to access those vaccines and not to have any differentiation in terms of whether or not they have a low CD4, high CD4 or suppress viral load or not.

All should be in line for vaccines.

Vismita Gupta-Smith

Thank you, Meg. That was Science in 5 today. Until next time then. Stay safe, stay healthy and stick with science.