The indirect impact of COVID-19 on HIV morbidity and mortality

A number of studies over the past twelve months have differed in their conclusions when it comes to the risk COVID-19 poses to people living with HIV. Some found no difference in the incidence and outcomes of COVID-19 for people living with HIV, whilst others found just the opposite.

Now, a group of British researchers have published an article in the journal Clinical Infectious Diseases where they present data on the indirect impact of the COVID-19 pandemic on HIV morbidity and mortality. The authors draw attention to how the pandemic has, and continues to, affect the lives and health of people living with HIV.

The researchers noticed that at the end of the first wave of COVID-19 in Europe that there was an increase in the number of people living with HIV hospitalised with advanced HIV. They compared HIV inpatient data from Chelsea and Westminster NHS hospitals for the period from July to October 2020 with the same period in 2019.

Although the study authors saw a reduced number of hospitalisations in 2020 they observed a significantly higher proportion of admissions due to AIDS defining illnesses. Whilst in 2019 26.5% of HIV inpatient admissions were due to a AIDS defining illness (48% cancer, 52% opportunistic infection) in the same period in 2020 over half (54%) of admissions were due to an AIDS defining illness (72% with an opportunistic infection and 28% with cancer).

The results show that patients being admitted in the second half of 2020 had more advanced HIV infections that the same period in 2019. The authors believe that this is due to isolation, difficulties accessing healthcare and treatment, and reluctance to visit healthcare facilities during the pandemic.

“Therefore, when considering the impact of the pandemic on people living with HIV, it is important to consider the additional implications of access to HIV testing and diagnosis, and the link between people and health care, which ultimately leads to increased incidence,” the authors conclude.