December 1 is World AIDS Day, a day which was set by World Health Organisation to focus the world’s attention on HIV/AIDS. In 1981, when the first case of Acquired Immune deficiency Syndrome (AIDS) was detected, the world was clueless about how to handle it. Being diagnosed with AIDS was like a death sentence for the individual. The diagnosis itself sent the patient in depression, associated social stigma which added to the anxiety and depression. With advent of first antiretroviral drugs around 1985, a ray of hope was seen. Later on with generating more awareness among people about HIV/AIDS, advent of more antiretroviral drugs, implementation of effective HIV/AIDS control programmes, it has been stabilised. Rwanda has been a classic example where prevalence of HIV/AIDS has been brought down, due to effective planning and implementation of HIV/AIDS control programme till ground level.
Now just when HIV/AIDS problem was settling down, Covid-19 emerged in December 2019. Starting from Wuhan in China, it rapidly progressed as a pandemic by March 2020. Millions across the globe became sick and even died. Many survivors are still facing health issues like breathlessness, easy fatigue, hair loss, etc. and sudden deaths have occurred, post Covid-19 infection, due to heart attacks, strokes, etc. The pandemic had also affected HIV/AIDS control, due to disruption of testing and access to antiretroviral treatment, as transportation system was affected due to lockdowns and health personnel being engaged with Covid patients load.
There are many similarities between the two diseases. Both were new at the beginning, baffling the medical fraternity as to what is happening and how to manage it. The viruses causing these diseases were unknown previously, both cause multiple health problems, a stigma is attached to them, due to which people avoid any interaction with an affected person. This creates a scenario where a positive person unless very sick, avoids disclosing his sickness or seeking help in special clinics, for fear of discrimination. HIV/AIDS is also a disease where overall immunity of the individual is lowered. The available drugs help prevent progression of the disease, but do not cure it.
Therefore, people with HIV/AIDS have to be more careful as they are more vulnerable to acquire Covid-19 infection because of lowered immunity. Global data has shown that PLHIV (persons living with HIV), have a 38% greater risk of developing severe or fatal Covid-19 as compared to people without HIV infection.
Though the peak has died down, Covid is still occurring in endemic form in all nations. Hence, those with HIV/AIDS have to continue being vigilant and take precaution to avoid getting exposed and infected with Covid-19. It includes all the preventive measures like wearing a face mask, observing cough hygiene, maintaining a distance from others and frequent hand-washing. Taking Covid-19 vaccines will be very useful for them. Certain drugs used for HIV/AIDS have been found to be useful for Covid-19 infection as well. If on antiretroviral therapy, the affected person should continue to take these medicines regularly.
Many persons living with HIV/AIDS may have other comorbidities as well, like diabetes, kidney diseases, cancer, etc. This enhances their vulnerability to develop Covid infection and post Covid complications. Along with anti-viral therapy, many of them are on multiple drugs for symptomatic relief or comorbidities or side effects of drugs. Hence, if medicines are prescribed for Covid-19 infection, the person should inform the healthcare provider about all medicines he/she is taking, so that any possible drug interaction (while taking two drugs simultaneously, one may reduce or enhance the effect of another thus reducing efficacy or increasing risk of toxicity) can be avoided or watched for.
Good personal hygiene and nutrition are two important issues to be taken care of, in case of an HIV/AIDS affected person who has tested positive for Covid-19 infection as well.
Caregivers of HIV/AIDS affected individuals should also be aware of these issues regarding Covid-19 infection. In case of any symptoms of Covid, they should be tested and treated promptly.
Dr Rachna Pande Specialist internal medicine
rachna212002@yahoo.co.uk