HIV meds do not protect against COVID-19

[Jim Allen]

Interesting study and data.

Aidsmap full article: https://www.aidsmap.com/news/aug-2023/no-antiretroviral-protects-against-covid-19-dutch-study-finds

In Brief:

Antiretroviral treatment with tenofovir disoproxil fumarate (TDF), etravirine or an integrase inhibitor does not reduce the risk of acquiring SARS-CoV-2 or severe COVID-19, according to an analysis of two Dutch national cohorts published in the journal AIDS.

The findings disagree with a Spanish study, published in 2022, which found that TDF was associated with a reduced risk of hospitalisation with severe COVID-19 in people with HIV over the age of 50.  They also contradict the findings of a US study that showed a reduced risk of symptomatic or severe COVID-19 in people taking TDF.

The AGEhIV cohort consisted of 239 people with HIV aged over 45, with a median age of 62 years, followed between September 2020 and April 2021 to determine the incidence of SARS-CoV-2 and hospitalisation due to COVID-19. Participants had been living with HIV for a median of 21 years, all but one was virally suppressed and the median CD4 count was 670. During the follow-up period, 29 of 239 people acquired SARS-CoV-2.

The ATHENA cohort includes 98% of all people with HIV in the Netherlands. There were 2189 participants who were diagnosed with COVID-19 while receiving antiretroviral treatment. Their median age was 50 years, they had been living with HIV for a median of 12 years, the median CD4 count was 710 and 98% had suppressed viral load. Severe COVID-19 was diagnosed in 158 people; of these, 29 died.

The risk of severe COVID was greater in older people, those of non-White origin, people with more co-morbidities and those living with HIV for longer. People diagnosed with severe COVID-19 had lower median CD4 counts and were more likely to be taking a protease inhibitor. But after adjusting for risk factors, the researchers found no association between any antiretroviral drug and reduced or increased risk of acquiring SARS-CoV-2 or severe COVID-19.

After controlling for age, sex at birth, ethnicity, co-morbidities, viral load, CD4 count and prior AIDS, the researchers found no reduction in the risk of either SARS-CoV-2 infection or severe COVID-19 associated with any antiretroviral in the AGEhIV cohort.