COVID-19 and HIV—Interaction, clinical course, outcome, and prognosis

Introduction: Coronaviruses were traditionally associated with mild respiratory illness until the emergence of SARS-CoV, MERS-CoV, and more recently SARS-CoV-2, the causative agent of COVID-19. HIV infection, characterized by progressive immunosuppression, raises important considerations in the context of SARS-CoV-2 co-infection. Aim: The aim of this article is to evaluate the clinical, immunological, and therapeutic intersections between HIV and COVID-19. Materials and Methods: A targeted review of peer-reviewed literature and relevant clinical data was conducted to explore the interaction between SARS-CoV-2 and HIV, focusing on clinical course, outcomes, and prognosis in co-infected patients. Results and Discussion: Current evidence indicates that HIV-positive individuals, particularly those receiving antiretroviral therapy (ART), are not at significantly increased risk of severe COVID-19 compared to the general population. In certain cases, lower CD4+ T-cell counts may attenuate hyper-inflammatory responses such as cytokine storm. However, co-infection may elevate thrombotic risk and complicate clinical management. The COVID-19 pandemic also disrupted HIV care and treatment continuity, potentially affecting long-term outcomes. Conclusion: While current data are reassuring regarding COVID-19 severity in HIV-positive patients on ART, the evolving nature of SARS-CoV-2 and the persistent global burden of HIV underscore the need for continued research and preparedness in managing of this co-infection.