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SA scientists sound warning on HIV link to new Covid-19 variants

People with the Aids virus and others with compromised immune systems do not respond well to vaccinations, experts say

05 December 2021 - 00:00
Professor Salim Abdool Karim says HIV has become a side issue as the world focuses on Covid-19.
Professor Salim Abdool Karim says HIV has become a side issue as the world focuses on Covid-19.
Image: SANDILE NDLOVU

South African health experts are urging the world to keep up the battle against HIV at the same time as it fights Covid, warning that failure to do so will help new variants of the coronavirus emerge. 

In the week that World Aids Day was observed, infectious disease epidemiologist professor Salim Abdool Karim said that with attention focused on Covid, HIV had become a “side issue” and might never regain its prominent position on the public health radar.

Africa accounts for the biggest incidence of HIV in the world, with 70% of cases.

“The world is now going to focus on acute pandemics and not HIV,” Karim said. “New variants develop in people who are immuno-compromised because they have very little immunity. This includes transplant recipients, advanced cancer patients, uncontrolled HIV. HIV is one small part of this group.

“The problem is that immuno-compromised people don’t respond well to vaccinations. A large proportion don’t develop immunity with two doses of the Pfizer vaccine. It is now recommended by the World Health Organisation that they should be given a third, and even a fourth dose.”

Karim said there is international concern about the number of new HIV infections. 

In Numbers:

1.5-million - the number of new HIV infections globally every year

66% - the proportion of HIV patients who are virally suppressed

“Globally, we still see 1.5-million new HIV infections [a year]," he said. “We are way off target. We were supposed to be at 500,000 last year. Our strategy to deal with HIV is based on treatment as prevention. Overall we are supposed to have 73% of all HIV patients globally virally suppressed, but at the moment we are at 66%.

“There has been good progress. But the good progress has not had an impact on slowing the number of new infections,” Karim said.

“We are lagging behind in terms of slowing the HIV epidemic … The rate of new infections in Africa, particularly Sub-Saharan Africa, is driven by the high rate of HIV in young women. There are several studies that show that the rate of infection in Africa as a whole is declining. But in young women, including in South Africa, it’s not declining.”

In an article in science journal Nature, South African clinicians and scientists, including professor Tulio de Oliveira, called on governments everywhere to devote more attention and resources to interactions between Covid and HIV. “As the world shifts gear in the Covid-19 pandemic — from tackling the immediate crisis to a long-term public-health response — we urge governments, health ministries, researchers and other stakeholders worldwide to devote more of their resources and attention to the interactions between Covid-19 and HIV,” the authors said.

“Various studies from before the rollout of Covid-19 vaccines show that people with HIV are 30%-50% more likely to die from Covid-19.

“What’s more, a failure to tackle the pandemic with sufficient urgency in countries with high rates of uncontrolled, advanced HIV could lead to the emergence of variants of the coronavirus SARS-CoV-2 that spread more easily between people or render the vaccines less effective.

“Conversely, both diseases could be curbed more effectively if they are tackled simultaneously, with public-health responses strengthened by the lessons learnt from both,” the scientists said.


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