Questions and answers: HIV and coronavirus (COVID-19)

COVID-19 is a respiratory disease caused by the recent SARS-CoV-2 coronavirus. Whilst thus new virus was first detected in Wuhan, China, in December 2019 it has spread worldwide.

According to the latest data, you can only get coronavirus through the drops that the COVID-19 patient secretes during sneezing or coughing.

It is known that the new coronavirus (SARS-CoV-2) can be detected in aerosols (small drops) for up to three hours, on copper (for example coins) - for up to four hours, on cardboard - for up to 24 hours, on plastic and stainless steel - for up to two to three days.

Detecting a virus, for example, on plastic for up to 3 days, does not mean that you can get infected through plastic, because the amount of virus on its surface is not enough to infect you.

If you know or suspect that a person who has become ill with COVID-19 may have been in close contact with clothing, bedding, food, etc., it is recommended to wash the items thoroughly.

The most common symptoms of COVID-19 are:

• Fever
• Fatigue
• Dry cough

Additionally, some patients may experience:

• Aching limbs
• Headache
• Nasal congestion or runny nose
• Sore throat
• Loss of smell and/or taste
• Diarrhoea

Based on current information, symptoms may appear as early as three days after infection and up to 13 days later. The average incubation period (time from infection until symptoms) is about 5 days.

About 80% carry the virus in a mild form.

About 20% hospitalisation is required.

About 5% require intensive care.

About 2.3% require mechanical ventilation.

Currently, the mortality rate of COVID-19 is estimated at 3-4%, which is less than that for SARS (about 11%) or MERS (about 35%), but is higher than the seasonal flu (which is on average is about 0.1%).

Elderly people (over 65 years old) are automatically considered to be at higher risk, as well as people of any age with pre-existing serious medical conditions, including:

• Lung disease (including asthma, COPD (chronic bronchitis or emphysema)),
• Heart disease (including coronary heart disease and congenital heart disease) and high blood pressure,
• Diabetes,
• Any condition or treatment that weakens the immune response (cancer, cancer treatment, organ or bone marrow transplantation, immunosuppressants, HIV with high viral load and/or CD4 count below 200 cells/μl).

This is a new virus and our understanding of the virus is rapidly evolving, however there is currently no evidence that people living with HIV are at greater risk of infection.

However common sense says that anyone with high viral load and/or CD4 count below 200 cells/μl is at more risk of opportunistic infection. If you’ve been diagnosed with HIV and not already on treatment, please speak to your clinic about starting treatment.

No, if your CD4 count is above 350 cells/μL.

If your CD4 count is below 350 cells/μL, then the latest data indicates that people living with HIV are three times more likely to experience severe COVID-19 symptoms. Also, the risks of developing complications increases with age, amongst the male population and the presence of chronic diseases such as arterial hypertension, cardiovascular disease, chronic lung disease, obesity and diabetes.

To avoid these complications, you need to start taking antiretroviral therapy immediately, if you have not already started it, and if possible, get vaccinated against COVID-19.

• Wash your hands with warm water and soap for 20 seconds or more. If soap & water are not available use hand sanitising gel.
• Avoid touching your face with your hands.
• When sneezing or coughing, cover yourself with your elbow, not the palm of your hands.
• Stay at home whenever possible. Physical isolation does not mean social isolation. Set up a home office and remain connected with friends and family using technology (such as Skype and Facetime).
• If you have to leave your home (for example, to work, to buy food or visit a pharmacy) you should keep at least 1 meter distance from other people.
• Wear a mask in public.
• Avoid close contact with anyone who is displaying COVID-19 symptoms.
• Ventilate the room more often.
• Get vaccinated against COVID-19 if possible.
• Make sure you’re vaccinated, in line with your local guidelines, for influenza and pneumococcus.
• Ensure you have an adequate supply of antiretroviral therapy (minimum 1 month).

Leading scientific organisations are unanimous in the opinion that people living with HIV can and should be vaccinated against COVID-19, if possible. Vaccination prevents infection with COVID-19, and in case of illness, prevents the more severe cases of the disease and the development of complications. Moreover, in a number of European countries, people living with HIV have been included in priority vaccination groups.

Vaccines are safe for everyone, including people living with HIV. The main contra-indication is the presence of an allergy to the vaccine or its individual components.

It is fine to use any available vaccine. All approved coronavirus vaccines have passed the necessary stages of clinical trials for efficacy and safety. Moreover, these tests are ongoing, and every case of an adverse reaction is recorded, so that up-to-date information on their safety is available.

More information on vaccines, contra-indications and dosages can be found in the article with answers to the most frequently asked questions.

Additionally in а special material of World Health Organization «Coronavirus disease (COVID-19): COVID-19 vaccines and people living with HIV».

There are different recipes for the preparation of antiseptics or disinfectants. The main component of these products, which completely disinfects, is alcohol (ethyl, isopropyl, etc.), with a concentration of 70-80%.

In the majority of cases COVID-19 proceeds in a mild form similar to the common cold. If you experience COVID-19 symptoms, stay home and AVOID any contact with people (except those with whom you already live together). Ask your friends/neighbours to buy/collect medicines and food for you. In order to not infect them, ask them to leave food packages at the door.

Use the over-the-counter medicines you normally would use for a cold to reduce your symptoms. Do not take antibiotics, they do not work on the Coronavirus. Do not experiment with new medicines!

If your symptoms worsen and you have a high fever or difficulty breathing, contact your local Coronavirus hotline or your doctor via telephone. They will advise you of any next steps.

Yes. It is possible.

EMA (European Medicines Agency) and FDA (Food and Drug Administration in the USA) , both confirm that there is currently no scientific evidence establishing a link between ibuprofen and worsening of COVID‑19.

Use the over-the-counter medicines you normally would use for a cold to reduce your symptoms. Do not take antibiotics, they do not work on the Coronavirus. Do not experiment with new medicines!

According to recent studies, using the antiretroviral combination lopinavir / ritonavir (Kaletra) and other investigational drugs (remdesivir, hydroxychloroquine and interferon) has been shown to have little or no benefit for the treatment of COVID-19. When compared with standard clinical practice, they had little or no effect on overall mortality, onset of ventilation, and length of hospitalisation of patients.

Other uses for these drugs, such as for the treatment of patients outside of health care settings or for prophylaxis, are to be investigated in other clinical trials.

So far, only corticosteroids have been proven to be effective against severe and critical COVID-19. Trials are ongoing for the antibiotic azithromycin, the immunosuppressant tocilizumab, plasma from recovered patients and the REGN-CoV2 monoclonal antibody cocktail.

There is currently no evidence that antiretroviral therapy helps or even protects against coronavirus infection. People living with HIV should follow the same prevention methods as the general population, be vigilant and not think they have any additional protection. This is also not a reason to change the therapy regimen and stock up on drugs involved in experimental treatment.

According to recent reports, wearing a mask or face covering (medical and non-medical) can protect against infection by the virus, as well as provide protection to others if a person has respiratory symptoms.

Wearing a mask or face covering is especially recommended when it is impossible to ensure physical distance (at least 1 metre), for example, in public transport, in shops or other confined spaces and crowded places, as well as in areas with mass circulation of the virus and limited opportunities to take other preventive measures.

WHO recommends wearing medical masks for the following population groups:

• Medical professionals;
• All individuals with symptoms suggestive of possible COVID-19 infection, including those with mild symptoms;
• Caregivers for patients with suspected COVID-19 or confirmed coronavirus infection outside health care facilities;
• Persons over 60 years old;
• Persons of any age with concomitant diseases.

It should be remembered that wearing a mask or face covering alone does not provide an adequate level of protection against infection. It is also necessary to maintain a distance of at least 1 metre from others, regularly wash or disinfect hands and avoid touching the face or mask with your hands.

If you find yourself in quarantine abroad, whilst on official work or studying, then you will most likely already have state or government insurance, giving you the right to receive free ARV medication. We recommend you go to the nearest clinic or doctor that deals with HIV. Everything remains confidential. Your data will not be transferred to any employer or authority. This confidential medical information will be respected at all times.

If you find yourself abroad as a tourist and do not have local state or government insurance, we recommend that you contact the nearest organization supporting people living with HIV or the local Red Cross.

If you are unable to contact the clinic/doctor or local organizations, please contact us:

If you have tried all possible ways to get ARV medication abroad, but could not achieve your goal, or you are in a place where there is no way to get medication (for example, in a remote region of the world or on an island), then we advise you to try to “stretch” your current stock of therapy for the longest possible time. There are studies (DODO, FOTO, BREATHER, etc.) that confirm that taking ARV therapy every other day is possible without loss of effectiveness and the risk of virus resistance. If, for example, you have a two-week stock of medicines, then you can easily “stretch” it for 4 weeks. By then, you will probably have the opportunity to fly back home.

If you have come to the end of your ARV medication, with no way to get more medication, then a break in treatment for up to 10-14 days will not pose a threat. The virus will not have time to recover during this time. If you are able to return home or get out of quarantine, to get a fresh supply of the same medication, during the ARV medication treatment break (up to 10-14 days), then you can continue taking the same medication without any restrictions. If the termination of medication has lasted for more than two weeks, then your viral load is likely to have increased. We recommend you contact your doctor if you arrive in your country of residence. Having a detectable viral load for some time is not critical and does not able to lead to complications. At the same time, it is extremely important to remember that during sex it is necessary to use condoms, since your viral load will no longer be undetectable.

If you have a scheduled appointment with a doctor in the coming days or weeks, contact your doctor in advance. If your condition is stable, then you do not need to meet with the doctor personally and it will be enough just to pick up a prescription or medication for a certain period. Remember: hospitals are overcrowded now, and doctors are overloaded. Consider others and show solidarity and respect!

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