Ural federal university: UrFU and New Zealand Scientists Researched HIV/SARS‐CoV‐2 Coinfection Cases

Scientists from the Ural Federal University and the University of Otago (New Zealand) studied international experience describing the practice of Covid-19 disease in people with the immunodeficiency virus. They found out whether people with HIV are at increased risk of contracting coronavirus, whether their illness is more severe, or whether antiretroviral drugs to increase immunity protect them, and inhibitors prevent the virus from multiplying in the body.

The results of the study are published in the Journal of Medical Virology.

“Most patients took inhibitors to suppress viral load before they were diagnosed with Covid-19. However, this did not prevent the progression of the coronavirus to a severe form. The analysis showed that despite the fact that the majority of patients with suppressed viral load successfully recovered, there is no evidence of a relationship between the status of suppression of the virus and the severity of Covid-19 or the death of patients,” says the co-author of the article, Junior Researcher at the Department of Organic Synthesis Technology UrFU Osman N. Kanwugu.

Covid-19 had more HIV-infected men – 72.3% of cases. This is probably also due to the fact that, in general, according to WHO, there are more registered cases of coronavirus among men than women. The disease proceeded with complications, required oxygen therapy, hospitalization in 36% of the coinfected (men and women). The remaining 64% are mild to moderate cases.

The researchers also found that standard antiretroviral therapy does not protect immunocompromised people from severe Covid-19 or death. And immunosuppressants, in turn, can increase the risk of a severe course of Covid-19.

“It is known that diseases such as hypertension, diabetes, respiratory, cardiovascular, hepatitis and others are risk factors that complicate the condition in coronavirus and often lead to deaths. Among coinfected people, 63.7% had at least one other comorbid condition. Therefore, the cause of high mortality – 14% – among the coinfected was not only the immunodeficiency virus, but also concomitant diseases. On the other hand, HIV infection is usually characterized by various concomitant diseases, and associated morbidity and mortality are inevitable,” the researcher states.

Among the known cases of coinfected patients, 14% are fatal. This is twice the global mortality rate for HIV patients before the pandemic.

“In the UK, USA, Germany, the case fatality rate among coinfected people is more than twice as high as in the general population. Of course, there are countries where the case fatality rate for people with HIV and Covid-19 is lower than the death rate for the general population. For example, in Spain, 3.6% of deaths are among those coinfected, while the death rate is 11.3%. In Italy it is 4.3% versus 14.4%, respectively,” notes Parise Adadi, PhD student and research fellow at the University of Otago.

Scientists believe that the differences in death rates from Covid-19 between countries are explained by a number of factors, including the availability of coronavirus testing, demographic characteristics, development of the healthcare system, and others.

“The first case of HIV / Covid-19 co-infection has been reported in Wuhan, China. Subsequent cases of co-infection have been identified in the UK, USA, Spain, Italy, Germany and other countries. It is noteworthy that across the African continent, only two cases of co-infection have been recorded, despite the fact that coronavirus is currently raging in South Africa and more than 8 million HIV-infected. The situation in Africa can probably be attributed to uncoordinated work and insufficient data collection by staff in hospitals and health centers, as well as a lack of enthusiasm among scientists to conduct research on this topic and publish results in scientific journals,” explains Kanwugu.

Osman Kanwugu is a postgraduate student of the Institute of Chemistry and Technology of UrFU, author of 15 publications in journals indexed by WoS and Scopus. In 2020 he was enrolled in a joint postgraduate study at UrFU with Macquarie University (Australia) with a Cotutelle scholarship.

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