COVID-19 not a risk factor for moderate HIV-positive patients — SA study

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HIV is not a risk factor for moderate or severe COVID-19 disease, neither is it a risk factor for mortality, found a South Africaa study in the Journal of Infection.

South Africa has the highest prevalence of HIV in the world and to date has recorded the highest number of cases of COVID-19 in Africa. There is uncertainty as to what the significance of this dual infection is, and whether people living with HIV (PLWH) have worse outcomes compared to HIV-negative patients with COVID-19. This study compared the outcomes of COVID-19 in a group of HIV-positive and HIV-negative patients admitted to a tertiary referral centre in Johannesburg.



Data was collected on all adult patients with known HIV status and COVID-19, confirmed by reverse-transcriptase polymerase chain reaction (RT-PCR), admitted to the medical wards and intensive care unit (ICU) between 6 March and 11 September 2020. The data included demographics, co-morbidities, laboratory results, severity of illness scores, complications and mortality, and comparisons were made between the HIV-positive and HIV negative groups.


Three-hundred and eighty-four patients, 108 HIV-positive and 276 HIV-negative, were included in the study. Median 4C score was significantly higher in the HIV-positive patients compared to the HIV-negative patients, but there was no significant difference in mortality between the HIV-positive and HIV-negative groups (15% vs 20%, p = 0.31). In addition, HIV-positive patients who died were younger than their HIV-negative counterparts, but this was not statistically significant (47.5 vs 57 years, p = 0.06).


Our findings suggest that HIV is not a risk factor for moderate or severe COVID-19 disease, neither is it a risk factor for mortality. However, HIV-positive patients with COVID-19 requiring admission to hospital are more likely to be younger than their HIV-negative counterparts. These findings need to be confirmed in future, prospective, studies.


Study details

Comparison of outcomes in HIV-positive and HIV-negative patients with COVID-19

 Authors: Jacqui Venturasa, Jarrod Zamparinia, Erica Shaddocka, Sarah Staceya, Lyle Murraya, Guy A Richardsa, Ismail Kallaa, Adam Mahomeda, Farzahna Mohameda, Mervyn Mera, Innocent Maposab, Charles Feldman

Published in Journal of Infection June 2021 (Restricted access but open until 25 July 2021)


Full Journal of Infection study (Open access until 25 July 2021)


See also from the MedicalBrief archives:


HIV patients: Low CD4 cell count may increase COVID-19 mortality threefold


No increased COVID-19 mortality for people with HIV — large US cohort analysis


COVID-19 outcomes and immune function in people with HIV — NY cohort study


People with HIV not at higher risk of death or severe illness from COVID-19


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