WHO official explains Covid-19 risks for persons living with HIV

Health Watch

If you are living with HIV
(human immunodeficiency virus),
what are your risks?
Should you be prioritised
for vaccination?
Dr Meg Doherty of the World Health Organisation (WHO)

What risk does the coronavirus (Covid-19) pose to people living with HIV?
Dr Doherty: We are becoming more aware and it’s now confirmed that people living with HIV have an increased risk for severe disease from the Covid-19 as well as hospitalisations.
Then once hospitalised, they have a 30 per cent increased risk of death.
So this is quite an important new statistic we are taking seriously at the WHO.
Something that helps people around the world to think about prioritising testing, treatment and management of hypertension and diabetes among people living with HIV.
This is also important because we know during the Covid-19 pandemic, we have seen a reduction and access to prevention services, testing services for HIV.
These kinds of services are the ones that we need to restart and maintain so that all people living with HIV have access to the anti-retrovirals they need, they find out if they’re living with HIV and also now start to be prioritised and have access to the Covid-19 vaccines.

Should people living with HIV be prioritised for vaccinations?
Considering that people living with HIV have a 30 per cent increased risk of death if they are hospitalised and that we know vaccination for the Covid-19 protects people from both having severe disease and hospitalisation and death – absolutely.
People living with HIV should be prioritised for early Covid-19 vaccines.
The WHO has been looking at the vaccines to see if they’re safe for people living with HIV.
All vaccines currently on the market can be used among people living with HIV and certainly should provide adequate protection.
There are many studies looking at whether people who have low immunity or people who have immunosuppression need to have another dose of vaccine.
Those data are not yet clear.
We’ll be looking forward to knowing whether people living with HIV might need a booster shot in the future.
In the low and middle income countries, in Africa which has the highest burden of HIV, they don’t even have the first vaccine.
So certainly, we urgently need to start vaccinating people around the world and putting people living with HIV right up there in the line of people who need vaccines, along with people with comorbidities, who are older, who are front line workers.

What about the safety of the current batch of vaccines for people living with HIV?
What we know so far for all the vaccines that are under emergency use right now around the world, they should all be safe in people living with HIV.
None of them are using live attenuated vaccines approaches which have been contraindicated in the past for people living with HIV. All of these vaccines that are out there now should be efficacious.
We want to ensure that people living with HIV are on treatment.
There are some concerns that people who are taking some of the newer vaccines, that they may not be as effective in those who have very low CD4 counts, people who are not on treatment or have immunosuppression.
But certainly, that data is not clear yet.
We have to follow this as we learn more about some of the clinical trials that are happening in South Africa for some of these newer vaccines.
We would be encouraging people living with HIV to access those vaccines and not to have any differentiation in terms of whether or not they have a low CD4, high CD4 or suppress viral load or not.
All should be in line for vaccines.