from LONG COVID ESSENTIALS
a resources series by The Sick Times x Long COVID Justice
People with HIV (human immunodeficiency virus) may be more at risk of severe COVID-19 illness from SARS-CoV-2 infection. This is especially true for people with untreated or advanced HIV, which can weaken the immune system and increase the chances of acute COVID-19 complications.
Additionally, early research has shown that people with HIV may be at higher risk for developing Long COVID. We don’t know for sure, but this may be due to chronic HIV-related conditions that COVID-19 can exacerbate.
If you have HIV and test positive for COVID-19, seek medical advice for treatment as quickly as possible.
If you have COVID-19 symptoms, it’s important to test for the disease. Use PCR or molecular tests if you have access to them. Rapid tests are more accurate if you use them two or three times over the course of several days. If you test positive, consider treatment. This is important for people with HIV because a compromised immune system heightens the risk of severe COVID-19 complications.
It is important to know that some medications prescribed to treat COVID-19, such as Paxlovid, can interact with HIV medications or other medicines that people living with HIV may be taking. If you take medication to manage HIV or other chronic health conditions, and are able to consult a health care provider, they can advise on drug interactions and contraindications, as well as whether and how to prioritize certain treatments.
Current recommendations do not advise stopping or changing HIV medication while on Paxlovid. This is a complex medical decision that must be supervised by a health care professional.
People living with HIV may be at higher risk for Long COVID.
Several studies have now shown that people living with HIV may be at higher risk for Long COVID than people who don’t have HIV. We don’t fully understand why yet.
One possibility is that people with HIV may have weakened immune systems, even if they are on HIV treatment. This can make them more at risk from to COVID-19. Individuals living with HIV may also have other prior health conditions and comorbidities that are associated with a higher likelihood of developing Long COVID.
Some of these conditions or factors include:
- Persistently high levels of inflammation
- Other forms of the immune system not functioning normally
- Type 2 diabetes
- Heart disease
- Mild problems with thinking or memory
- Mental health conditions
- Substance use
- Age 50 or older
Additionally, many structural factors can impact people with HIV, such as having lower income and lacking access to stable housing or medical care. These can make the severity of COVID-19 worse.
Viral pandemics have a terrible way of exposing how much structural inequalities impact our health. For example, many people living with HIV are from racial and ethnic groups disproportionately impacted by both HIV/AIDS and well as SARS-CoV-2/COVID-19.
Tests and treatments for COVID-19 can be expensive and time-consuming, which makes it more difficult for individuals to manage and recover from an infection.
Differentiating symptoms: Is it HIV or Long COVID?
If you are living with HIV and suspect you have Long COVID, consider tracking new or unusual symptoms, if possible. This may help differentiate between symptoms common with both HIV and Long COVID. For example, sudden changes in cognitive abilities (thinking) may be worsened by COVID-19, not simply the result of aging while living with HIV. Tracking symptoms may illuminate a pattern of subtle health changes otherwise forgotten or overlooked. It can make it easier for you to discuss these symptoms with your healthcare provider.
Fatigue is a common symptom of Long COVID, as well as HIV disease. Tracking symptoms and learning about fatigue and post-exertional malaise can help you consider if new or worsened fatigue or symptoms after physical, mental, or emotional activity may be from Long COVID.
Research into Long COVID and HIV is helping us better understand both diseases better.
Many advances in COVID-19 research were made possible by prior investments in HIV research. Now HIV research is adapting many lessons learned from the development of COVID-19 prevention and treatment strategies.
Further research is needed, but some researchers are investigating whether HIV antivirals Truvada and Maraviroc may be effective in treating Long COVID symptoms.
Studies have also indicated that metformin, a drug used to treat Type 2 diabetes, may benefit people with HIV as well as those with Long COVID.
Resources
- Information about HIV and Long COVID — Long COVID Justice
- Article explaining why HIV may increase the risk of Long COVID — The Sick Times
- COVID-19 in people with HIV — HIV.gov
- More about HIV and COVID-19 — NIH
- Potential Long COVID treatments drawing on HIV research — Bloomberg
- More evidence that Long COVID is more common in people with HIV — AIDSmap
- Long COVID support groups, including a group for people living with HIV who have Long COVID – Long COVID Justice
Writer: Britta Shoot • Editor: Miles Griffis • Medical reviewer: Dr. Michael Peluso
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Notes
- This series was published in fall 2024; some information may be subject to change.
- Although each topic has been reviewed by medical professionals, they are informational resources, not medical advice. Always talk to your medical providers before trying treatments or symptom management strategies.
- Each resource page offers brief information and is not comprehensive. We know there is much more information on each topic we cover, and that there are additional topics not yet addressed in this series.