Are Patients With HIV at Increased Risk for COVID-19?

[MUSIC PLAYING] Hi, everyone. I'm Dr. John Whyte, chief medical officer at WebMD. And today I want to talk about HIV and its relationship to COVID. So I've asked my good friend Dr. Virginia Banks, an infectious disease and HIV specialist in Youngstown, Ohio. Dr. Banks, how are you?

Thank you. Thank you for having me. I'm fine.

Let's start off with, we talk a lot about risk factors-- heart disease, diabetes-- perhaps putting you at increased risk for getting COVID. What about HIV?

Well, I'm happy to say we have an aging population with HIV now and a significant number of our population with HIV, they're over the age of 50, 55, which certainly puts them at increased risk for COVID. And many of them have comorbid illnesses like obesity, which we know now is a significant independent risk factor for acquiring COVID-- hypertension, diabetes, heart disease, and all of these. So that is what catapults them into being more susceptible, I believe, for COVID.

But HIV itself, if it's controlled, doesn't put one at increased risk for COVID.

That is correct. Having said that, having HIV and on highly active antiretroviral therapy, being under the care of your physician and taking your medication, and having an undetectable viral level, that seems to not put you at increased risk, which is why we continue to stress with those individuals make sure you continue to take your HEART therapy.

Do patients with HIV need to do anything differently to protect themselves. So let's assume they're taking their medicines as directed, they're seeing their doctor. Is it just the same as everyone else with the handwashing, the physical distancing, avoid the crowds?

It should be the exact same as everyone else, social distancing, as you said, washing your hands. One of the things that I would encourage is I would encouraged to any of my patients to make sure that your vaccinations are up-to-date, your influenza vaccination, your pneumococcal vaccines. So all of these things I would encourage my HIV patients to do just as I with my other patients.

Now, you and I talked briefly about early on, people may forget that some of the therapies that scientists and researchers were discussing for a possible COVID treatment were some of the HIV medicines that had been discovered a while back. Where are we on that? We're not hearing as much about them anymore?

Well, you have to remember these were all antiviral therapies, and coronavirus is a virus. And early on, we were using drugs like lopinavir getting some information from some of the other countries about using that. It hasn't gone away. They're still looking at drugs like lopinavir and some of the other antivirals, darunavir and tenofovir, as being possible therapeutics in treating COVID-19. But, thus far, we have no reason, at least at this juncture, to use them.

Now, there have been some reports of shortages of HIV medicines, perhaps related to this or other ideas, as well as PrEP treatment.

I've been doing some checking on that just because some of my patients have asked me about that. But, at least to date, I'm not aware personally of that with my patients, but what we have been encouraging our patients to make sure that they get at least a 30 to 90 day supply of their medications on hand. We certainly encourage them to do that.

Now, I wanted to ask you about this. I read an article recently that says some COVID-19 vaccines could increase risk of HIV, relating to adenovirus. Can you explain that? It's still very preliminary.

It is very preliminary. And, in fact, I was reading an article by Dr. Fauci a few days ago about this.

Always a good source, always a good source.

Always a good source. I'm not sure the mechanism of action with this. What we do know is that there are a couple of vaccines that are in the hopper where adenovirus is used as one of the organisms that's in the making of the vaccine as opposed to two of the others where messenger RNA is the mode of the substance is used for the vaccine. So today I don't have any information on it, it's just early information.

I don't even know whether it's anecdotal, because we certainly don't have a large population of patients. Right now none of those drugs have really been FDA-approved and I'm not really sure where we are in clinical trials with those drugs where the basis of the vaccine is adenovirus. But I think it is very interesting information, to just stay abreast of what's going on in terms of safety.

Dr. Banks, do you think COVID treatment may ultimately be like we treat HIV, that it will require multiple drug therapy as opposed to one drug or two drugs. Is that where we're headed you think with COVID?

I don't know. But as I was a witness to the evolution of drugs starting from AZT to what we have now, I would hope so. I'm hoping so because what we have now are drugs that are effective at different areas of the virus getting into the cell, drugs that effect the entrance of the vaccine into the cell, drugs that prevent replication in the cell. So I'm hoping that maybe we'll have a cocktail like we do with HIV. And I'm hoping that this disease will evolve like HIV has evolved.

What else do patients with HIV need to know when it comes to COVID-19.

Well, I think another thing that's being stressed, again, if you're taking your HEART therapy and you have an undetectable viral level, what we're also encouraging our patients to maybe look into telemedicine. That's a big thing now with patients and physicians. And if your health care facility has telemedicine, you might want to look into that as a means by which you can keep in contact with your physician and you don't have to come out into the open.

Well, Dr. Virginia Banks, I want to thank you for, again, sharing your insights about HIV. You said last time we've come--

A long way, baby.

Yes, we have that HIV is not even considered a risk factor for COVID, if it's being managed well. But we want to remind patients to make sure they take their medicines, see their doctor, as well as practice all the safeguards that everyone else is doing-- the mask wearing, hand washing, physical distancing, and avoiding large crowds. Thanks again for taking time.

Thank you for having me.

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