COVID-19 AND HIV CARE

The Academy is closely monitoring the spread of COVID-19 across our country, knowing that many of our members and credentialed providers are inevitably on the frontlines of combatting this pandemic while also continuing to take care of current patient loads. Without understanding the full effect COVID-19 may have on people living with HIV, it is imperative to take precautions in caring for this population. To that end, we have gathered the following resources of recommendations and special considerations for care and treatment of people with HIV during the COVID-19 pandemic.

Interim Guidance for COVID-19 and PWH

The following is a summarization of a few key points from DHHS’s first interim guidance for COVID-19 and persons with HIV provided by Academy Chief Medical Officer Dr. Jeffrey T. Kirchner.

Interim Guidance for COVID-19 and Persons with HIV – Updated: June 19, 2020

Current data is limited but do NOT indicate that the disease course of COVID-19 in persons with HIV differs from that in persons without HIV. Before the advent of effective combination ART, advanced HIV infection (CD4 cell count <200/mm3) was a risk factor for complications of other respiratory infections. Whether this is true for COVID-19 is yet unknown.

  • Persons aged >60 years (with or without HIV) and those with cardiovascular disease, hypertension, or pulmonary disease are at highest risk of life-threatening COVID-19. Persons with HIV and other comorbidities (e.g., cardiovascular disease or lung disease) are at increased risk for a more severe course of COVID-19 illness. Chronic smokers are also at risk of more severe disease.
  • Clinical sites and HIV medical providers should make every effort to help their patients maintain an adequate supply of ART and all other concomitant medications. This includes at least a 30-day supply—and ideally a 90-day supply of medications if possible.
  • Persons with HIV and their healthcare providers should weigh the risks and benefits of HIV-related in-person office visits at this time. Factors to consider include the extent of local COVID-19 transmission, health needs that will be addressed during the appointment, the person’s HIV status (e.g., CD4 cell count, HIV viral load) and overall health.
  • Telephone or virtual visits for routine or non-urgent care and adherence counseling may replace face-to-face encounters. For persons who have a suppressed HIV viral load and are in stable health, routine medical and laboratory visits should be postponed to the extent possible without negatively affective health and continued control of HIV infection.

Additional Resources

As part of the Academy’s continued commitment to provide relevant and useful information during the pandemic, please find additional resources listed below.

Considerations & Suggested Practices for Ambulatory HIV Specialty Care During the COVID-19 Pandemic

Interim Guidance for COVID-19 and Persons with HIV

Therapeutic Options for COVID-19 Patients

IDSA COVID-19 Resource Center

CDC: What to Know About HIV and COVID-19

National Pregnancy COVID-19 Registry

HRSA HIV/AIDS Bureau Coronavirus (COVID-19) Information

Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19)

Early virus clearance and delayed antibody response in a case of COVID-19 with a history of co-infection with HIV-1 and HCV

CURE HIV-COVID Registry

NIH COVID-19 Treatment Guidelines – UPDATED: July 17, 2020

COVID-19 Telehealth Resource Center

COVID-19 NEJM Journal Watch

Academy Webinar Recording: Tele-PrEP: Preventing HIV in the COVID-19 Pandemic

The Legacy of HIV/AIDS: Lessons for Today

JAMA: Interpreting Diagnostic Tests for SARVS CoV2 – May 2020

Clinical Features and Outcomes of HIV Patients with Coronavirus Disease 2019 – May 2020

Incidence and Severity of COVID-19 in HIV-Positive Persons Receiving Antiretroviral Therapy: A Cohort Study – June 2020

JAMA Review: Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19) – July 2020

HIV-Age.org Journal Articles

ASPR TRACIE TA: COVID-19 Clinical Experiences from the Field

New York State AIDS Institute’s Best Practices for Re-opening and the Provision of In-person Care – September 2020

SPANISH LANGUAGE RESOURCES:

The Academy with ANAC co-hosted a webinar on COVID 19: A Clinical Update for HIV Providers in April 2020. Please find a full recording with corresponding slides from our presenters below. Please note that once you click the above below, the webinar should begin playing automatically on your computer within 3-5 seconds. If not, and it says that there is no content available, please scroll to the bottom of the screen and press the play button.

COVID-19: A Clinical Update for HIV Care Providers

Corresponding slide deck presentations can be accessed here:

 

If you have additional recommendations, please share your thoughts within our Academy Communities. Given the unprecedented nature of this public health crisis, this should be a time of sharing of best practices in order to combat the pandemic.