Study: Lower COVID Risk for HIV-Positive People on Antiretrovirals

A study of tens of thousands of HIV-positive Spaniards found they faced less risk of dying or getting seriously ill from COVID-19 than people without HIV.

Researchers specifically cited the use of antiretroviral therapy — specifically medications that include a nucleotide reverse transcriptase inhibitor (NRTI) backbone of tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC) — as a factor in the lower risks, according to the study published in the Annals of Internal Medicine and reported in the American Journal of Managed Care. 

Nearly 78,000 HIV-positive people with COVID-19 were part of the study, occurring between February 1 and April 15. 

"Of the total patient cohort, just 0.3% (236) had [polymerase chain reaction]-diagnosed COVID-19," according to AJMC. "And among this group, 64% (151) required hospitalization, 6.4% (15) needed ICU care, and 8.5% (20) died."

Patients taking antiretrovirals with TDF/FTC had the lowest risk for COVID-related hospitalizations. Another fascinating finding, according to AJMC: "Compared with the general population, this risk for COVID-19 diagnosis was lower among persons with HIV: 30.0 vs 41.7 per 10,000 persons."

“We took advantage of the overlap between 2 ongoing pandemics (HIV and SARS-CoV-2) in Spain,” the investigators concluded. “Our results suggest that the risk for COVID-19 diagnosis is not higher in HIV-positive persons than in the general population, and that HIV-positive patients receiving TDF/FTC had a lower risk for COVID-19 and related hospitalization than other HIV-positive persons.”