Division of HIV, ID, and Global Medicine, University of California, San Francisco, California, USA.
Curr Opin HIV AIDS. 2021 Jan;16(1):63-73. doi: 10.1097/COH.0000000000000659.
We examine the interplay between the HIV and COVID-19 epidemics, including the impact of HIV on COVID-19 susceptibility and severe disease, the effect of the COVID-19 epidemic on HIV prevention and treatment, and the influence of the HIV epidemic on responses to COVID-19.
Evidence to date does not suggest that people living with HIV (PLWH) have a markedly higher susceptibility to SARS-CoV-2 infection, with disparities in the social determinants of health and comorbidities likely having a greater influence. The majority of literature has not supported a higher risk for severe disease among PLWH in Europe and the United States, although a large, population-based study in South Africa reported a higher rate of death due to COVID-19. Higher rates of comorbidities associated with COVID-19 disease severity among PLWH is an urgent concern. COVID-19 is leading to decreased access to HIV prevention services and HIV testing, and worsening HIV treatment access and virologic suppression, which could lead to worsening HIV epidemic control.
COVID-19 is threatening gains against the HIV epidemic, including the U.S. Ending the HIV Epidemic goals. The ongoing collision of these two global pandemics will continue to need both study and interventions to mitigate the effects of COVID-19 on HIV efforts worldwide.
我们研究了 HIV 和 COVID-19 流行之间的相互作用,包括 HIV 对 COVID-19 易感性和严重疾病的影响、COVID-19 流行对 HIV 预防和治疗的影响,以及 HIV 流行对 COVID-19 应对措施的影响。
迄今为止的证据表明,HIV 感染者(PLWH)对 SARS-CoV-2 感染的易感性并没有明显增加,健康的社会决定因素和合并症的差异可能有更大的影响。大多数文献并不支持欧洲和美国的 PLWH 发生严重疾病的风险更高,尽管南非的一项大型基于人群的研究报告称 COVID-19 死亡率更高。PLWH 中与 COVID-19 疾病严重程度相关的合并症更高,这是一个紧迫的问题。COVID-19 导致 HIV 预防服务和 HIV 检测机会减少,以及 HIV 治疗机会和病毒学抑制恶化,这可能导致 HIV 流行控制恶化。
COVID-19 正在威胁着 HIV 流行的防控成果,包括美国的终结 HIV 流行目标。这两种全球大流行的持续碰撞将继续需要研究和干预措施,以减轻 COVID-19 对全球 HIV 防控工作的影响。