COVID-19 and HIV

COVID-19, also called coronavirus disease 2019, is an illness caused by a virus, severe acute respiratory syndrome coronavirus 2, or more commonly, SARS-CoV-2. On March 11, 2020, after more than 118,000 cases in 114 countries and 4,291 deaths, the WHO declared COVID-19 a pandemic. In December 2020 the FDA granted Emergency Use Authorization to two vaccines, both of which proved highly effective. Despite the constant evolution of SARS-CoV-2, significant strides were made in the clinical case management of COVID infection. Also, because of this vaccination and the high population-level immunity from infection reduced the risk to human health, and the mortality rate significantly reduced over time. For the decreasing trend in COVID-19 deaths and a decline in COVID-19-related hospitalization and intensive care unit admission, the WHO on May 5, 2023, declared that COVID-19 no longer constitutes a public health emergency of international concern.

The recommendations for the triage, management, and treatment of COVID-19 in people with HIV are the same as those for the general population.

Henry Ford has treatment guidelines for Clinical management of COVID-19.

In addition to these guidelines:

  • People with HIV who are receiving a 5-day course of ritonavir-boosted nirmatrelvir (Paxlovid) to treat COVID-19 can continue using their antiretroviral therapy (ART) doses of ritonavir or cobicistat without alteration or interruption.
  • In patients with advanced HIV who have suspected or laboratory-confirmed SARS-CoV-2 infection, clinicians should consider HIV-associated opportunistic infections in the differential diagnosis of clinical.
  • When starting treatment for COVID-19 in patients with HIV, clinicians should pay careful attention to potential drug-drug interactions and overlapping toxicities among COVID-19 treatments, antiretroviral (ARV) medications, antimicrobial therapies, and other medications.
  • The COVID-19 Treatment Guidelines Panel (the Panel) recommends that people with HIV receive COVID-19 vaccines, regardless of their CD4 T lymphocyte (CD4) cell count or HIV viral load, because the potential benefits outweigh the potential risks
  • For people with HIV, the Panel recommends following the most recent COVID-19 vaccination schedule from the Centers for Disease Control and Prevention (CDC) 

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