What happens when patients with untreated HIV get Covid?
Leading South African scientists are set to investigate Covid-19 and HIV in tandem, amid mounting evidence that the collision of the two pandemics could be generating new coronavirus variants.
The team at the Network for Genomic Surveillance in South Africa (NGS-SA), which first alerted the world to the Covid variant Omicron, said it was time for a "systematic" investigation of what happens when patients with untreated HIV get Covid-19.
A number of studies, including one published by the team last week, have found that people with weakened immune systems – such as patients with untreated HIV – can suffer from persistent coronavirus infections, often for months.
The virus remains in their systems and accumulates mutations, some of which may give it an advantage.
Some researchers believe this could be how Omicron and some of the other Covid variants developed, although other scientists believe it may have arisen in animals before spilling back over into humans.
Tongai Maponga, lead author of the recent paper and a researcher at Stellenbosch University, said he and colleagues at the NGS-SA were discussing more in-depth study to support the hypothesis.
"The few cases that have so far been seen and described are happening just because of random surveillance," he told Reuters.
"But I think soon we will be doing something more systematic to look specially at these severely immunocompromised HIV patients, to see what is going on."
He said the work would focus on two elements: on the patients and how their systems deal with Covid-19 infection, and on proving whether new variants are likely to be emerging in this way.
"If that is the case we need to up our game with how we diagnose these people, and ensure that they are getting prompt diagnosis and treatment," he added.
Saoirse Fitzpatrick, advocacy manager at StopAids, said the pandemic had "severely" impacted HIV testing globally but that it was critical to address both public health challenges.
"A Covid response that leaves out the HIV response is not a sufficient public health approach," she said.
It was unclear how many patients were involved at this stage.
South Africa has the world's biggest HIV epidemic, with 8.2 million people infected. Only around 71 percent of adults, and 45 percent of children, are being treated.
Maponga added: "We must reiterate that we do not want to cause unnecessary stigma around HIV – this is the risk we take by raising these questions, but I think we need to be considering them."
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