The clinical course of HIV/ COVID-19 co-infection and approaches to its therapy

Objective. To investigate the course of COVID-19 and approaches to its therapy in patients with HIV infection. Patients. Eighty-five HIV-infected patients with coronavirus infection were examined. Their median age was 39 years. Seventy-six patients received ART. All had HIV RNA < 50 copies/ml; the median number of CD4+ lymphocytes was 602.5 cells/pl. Nine patients did not receive ART; the median number of CD4+ lymphocytes was 342 cells/pl; the median HIV RNA was 69 915.5 copies/pl. Concomitant diseases were present in 22.4% of the patients. Results. The diagnosis of the disease was confirmed by the detection of SARS-CoV-2 RNA in the nasopharyngeal swabs (PCR) of 45patients and by the presence of anti-SARS-CoV-2 IgG in the blood samples of 45patients. The disease was moderate and mild in 25.9 % and 74.1%, respectively. The clinical symptoms were absent or were less noticeable in 20% of the patients. The patients had fever (82.9%), weakness (75%), anosmia (53.9%), dry cough (35.5%), and dyspnea (5.3%). Lung CT changes were recorded in 28 out of 38 patients (CT3 in 1). No therapy for coronavirus infection was performed in 24.7% of the patients. 6.25% of patients received antiviral therapy; 15.6% took hydroxychloroquine in combination with antibacterial therapy (ABT); 75% had ABT; 21.9 and 4.9% used anticoagulants and corticosteroids, respectively. Conclusion. Coronavirus infection was mild in 3/4 of the patients with HIV infection, asymptomatic or subtle in 20%, which was probably due to the regular follow-up of this patient category, to effective ART in 89.4%, to the young age of patients, and to the absence of concomitant diseases in most patients.

COVID-19, HIV infection, COVID-19, ART