If you have HIV, you may be concerned that condition raises your risk for a bad case of COVID-19, the illness caused by the coronavirus. Although it's worth taking some extra precautions to protect yourself, whether or not you're actually at higher risk than anyone else likely depends on your current health status.
If your HIV is well-controlled -- meaning you’re on antiretroviral therapy (ART) that's successfully suppressing HIV and you have normal CD4 counts -- then you're not necessarily more apt to get very sick with COVID-19 than someone without HIV. Other types of coronaviruses, such as those that caused SARS and MERS, did not have a major impact on people with HIV. But if your HIV is advanced or isn’t under good control with antiretroviral therapy (ART), then your immune system will have a harder time defending you against infections, possibly including COVID-19. In that case, if you do get COVID-19, you may be more likely to have serious complications.
A worldwide study of HIV-infected people found they had a 38% higher risk of becoming very sick or dying from Covid. Other factors -- heart disease, high blood pressure, lung disease, and diabetes -- factor into the increased risk.
If you're not getting treatment or you have recently had blood tests that showed a low CD4 count and/or high viral load, you should assume that you are at high risk.
Other Risk Factors
Besides a weak immune system, which can happen if your HIV isn’t under control or if you take certain medications that suppress your immune system, other things also raise your risk of severe COVID-19 symptoms. They include:
- Older age. Your chances go up as you get older. The highest risk is among people 85 and older.
- Medical conditions such as cancer, kidney disease, heart disease, asthmas, chronic obstructive pulmonary disease (COPD), obesity, type 2 diabetes, sickle cell disease, or a weakened immune system because of an organ transplant
Still, most people who get COVID-19 don’t have severe complications.
What You Can Do
The most important thing you can do is to get vaccinated against COVID, and to keep up with boosters. Getting an annual flu shot is smart.
If you'll be in an indoor crowd you may want to consider masking up.
Also, keep at least a 30-day supply of your antiretroviral medications on hand. A 90-day supply is ideal, according to the National Institutes of Health. You may want to switch to mail-order delivery, so you don’t have to go out to get it.
What to Do if You Get COVID-19
As with most people who get COVID-19, people with HIV who have symptoms should generally stay at home and call their doctor. (Don’t just show up at the doctor’s office or the ER -- call first, so they’re ready for you.) According to the CDC, you're not contagious to others if for 24 hours your symptoms aren't noticeable and you don't have a fever (and aren't taking fever-reducing drugs).
Keep taking your antiretroviral medication as prescribed, and call your doctor if you become short of breath or have a fever for more than 2 days.
If you need to stay in the hospital because of COVID-19, the health care team there should keep giving you your usual antiretroviral drugs, whether you take them orally or by infusion (IV).
