Abstract
The concurrence of infection with human immunodeficiency virus (HIV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), presents an intriguing problem with many uncertainties underlying their pathogenesis. Despite over 96.2 million cases of COVID-19 worldwide as of January 22, 2021, reports of patients coinfected with HIV and SARS-CoV-2 are scarce. It remains unknown whether HIV patients are at a greater risk of infection from SARS-CoV-2, despite their immunocompromised status. We present a systematic review of the literature reporting cases of HIV and SARS-CoV-2 coinfection, and examine trends of clinical outcomes among coinfected patients. We systematically compiled 63 reports of HIV-1 and SARS-CoV-2 coinfection, published as of January 22, 2021. These studies were retrieved through targeted search terms applied to PubMed/Medline and manual search. Despite scattered evidence, reports indicate a favorable prognosis for HIV patients with strict adherence to combined antiretroviral therapy (cART). However, the presence of comorbidities was associated with a poorer prognosis in HIV/SARS-CoV-2 patients, despite cART and viral suppression. Studies were limited by geographic coverage, small sample size, lack of patient details, and short follow-up durations. Although some anti-HIV drugs have shown promising in vitro activity against SARS-CoV-2, there is no conclusive evidence of the clinical efficacy of any anti-HIV drug in the treatment of COVID-19. Further research is needed to explain the under-representation of severe COVID-19 cases among the HIV patient population and to explore the possible protective mechanisms of cART in this vulnerable population.
Keywords: COVID-19; HIV; SARS-CoV-2; antiviral; cART; coinfection.
【저자키워드】 COVID-19, SARS-CoV-2, HIV, Antiviral, Coinfection, cART, 【초록키워드】 Treatment, coronavirus disease, Coronavirus disease 2019, coronavirus, Pathogenesis, severe COVID-19, Antiviral, Prognosis, Infection, Comorbidities, systematic review, severe acute respiratory syndrome Coronavirus, clinical outcomes, Clinical outcome, Coinfection, Coverage, Viral, Antiretroviral therapy, HIV-1, Research, Patient, respiratory, Human immunodeficiency virus, patients, cART, Evidence, Clinical efficacy, in vitro activity, risk of infection, evidence of, causative agent, vulnerable population, protective mechanisms, protective mechanism, acute respiratory syndrome, treatment of COVID-19, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, immunodeficiency virus, small sample size, concurrence, HIV patients, immunocompromised status, greater, shown, lack, applied, anti-HIV drug, explain, with HIV, HIV patient, follow-up durations, presence of comorbidity, retrieved, 【제목키워드】 review, Human, coronavirus 2, challenge, literature,