• Older age, diabetes and hypertension each raised the risk of admission with severe illness in people with HIV.
• Several other studies had shown that people living with HIV have a raised risk of dying from Covid-19.
People living with HIV should be prioritised for Covid-19 vaccination because they are more likely to die if they develop severe Covid-19, health experts have said.
The decision was communicated last week by the World Health Organization, after a rapid survey of 100 countries.
Until now, vaccination in Kenya was prioritised for people above 58 years and those working in critical areas such as healthcare.
At least two million Covid-19 doses have been given in Kenya so far.
However, the WHO, through its Global Clinical Platform for Covid-19, has found that people with HIV are at higher risk of severe or critical illness at the time of admission.
To investigate the impact of HIV on Covid-19 outcomes, the WHO identified outcomes data for 15,522 people living with HIV from the platform from 24 countries, submitted up to April 29, 2021. The vast majority — 94.6 per cent — of these cases were reported from South Africa.
Just over one-third of people with HIV or 5,563 patients admitted to hospital had severe or critical Covid-19. Of these, 35 per cent died. Of those with mild or moderate illness at admission, 17 per cent died.
Older age, diabetes and hypertension each raised the risk of admission with severe illness in people with HIV.
“There’s a critical need for vaccine equity; in lower and middle-income countries we have only 3-4 per cent vaccine coverage and we need to get the first dose into everyone,” Dr Meg Doherty, director of WHO’s Global HIV, Hepatitis and STI Programmes told a press briefing at the ongoing online International Aids Society conference.
Dr Doherty also stressed the importance of stepping up testing activities.
“We have at least 10 million people who are unaware of their HIV status – we need to ensure that people are getting tested.”
The researchers looked at two outcomes in people living with HIV compared to the rest of the population: inpatient mortality, and severity of illness at admission to hospital.
Data on people living with HIV submitted to the platform did not include information on CD4 count and viral load so it was not possible to determine if these factors influenced outcomes in people living with HIV.
Currently, old age is by far the strongest known risk factor for death from Covid-19. People over 80 are at least 20 times more likely to die from Covid-19 compared to people aged 50-59. People under 40 years have a greatly reduced risk compared to the 50-59 age group.
This is according to the largest study of risk factors for severe Covid-19 conducted so far, the OPENSafely study.
Several other studies had shown that people living with HIV have a raised risk of dying from Covid-19.
However, studies have come to differing conclusions about how great the risk is, so data from published papers have been combined and analysed together in two meta-analyses, published in the medical journals Aids and Scientific Reports.
These concluded that HIV increased the risk of death from Covid-19 by between 78 and 95 per cent.