Having HIV is not an independent risk factor for severe COVID-19 and death amongst patients hospitalized with COVID-19, according to a Zambian study published in the Morbidity and Mortality Weekly Report.

However, patients with more severe HIV infections are more likely to develop severe COVID-19 or die of COVID-19 compared to those without complications.

“This finding is consistent with results from smaller studies among hospitalized patients in North America, Europe, and South Africa,” state the authors.

The results highlight that maintaining access, and support for adherence, to antiretroviral therapy (ART) is important for reducing the impact of COVID-19 on individuals and the healthcare system as well as for improving HIV outcomes.

Research into the effect of HIV on COVID-19 outcomes has so far yielded mixed results.

A large South African study found that having HIV doubled the risk of death from COVID-19, and these findings have been supported by two UK studies.

However, other research from the UK and US suggest that HIV is not an independent risk factor for more severe COVID-19 and death.

Like many sub-Saharan African countries, the prevalence of HIV in Zambia’s general population is very high (around 12%) and its healthcare system’s capacity to treat severe COVID-19 is limited.

Understanding whether HIV increases the risk of severe COVID-19 and death is therefore of urgent importance in this context.

Accordingly, a team of researchers led by Dr. Duncan Chanda of the Ministry of Health undertook a prospective cohort study of COVID-19 patients admitted for care in five specialised COVID-19 treatment centres in four Zambian cities between March and December 2020.

Their aim was to establish whether COVID-19 patients living with HIV were at greater risk of severe COVID-19, at admission or during hospitalization, and death.

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