SARS-CoV-2 infection in people living with HIV: a systematic review

Rev Med Virol. 2021 Jan;31(1):1-12. doi: 10.1002/rmv.2155. Epub 2020 Sep 1.


Background and setting: Little is known about SARS-CoV-2 impact on some vulnerable subgroups, such as people living with HIV/AIDS (PLWHA). In our study we reviewed the current knowledge on SARS-CoV-2 cases in PLWHA.

Methods: A systematic review was conducted by searching the MEDLINE, EMBASE and Google Scholar databases. Studies reporting data on PLWHA affected by SARS-CoV-2 were considered for inclusion. The aim of this study was the systematic characterization of cases of SARS-CoV-2 infection among PLWHA, particularly focusing on age, clinical findings at diagnosis, radiological features, therapeutic management and clinical outcomes.

Results: Twenty three relevant articles were identified, which reported 164 adults with both HIV and SARS-CoV-2 infection. Of those, the large majority were males (120/142, 84.5%), often with one or more comorbidities. Fifteen cases needed intensive care treatment and 16 died. For each group, respectively three patients had underlying comorbidities. There were no studies on children. The included studies were mostly retrospective or case series/reports (19 studies). The overall risk of bias was moderate, due to the study types and characteristics.

Conclusion: It is still unclear if HIV infection may influence SARS-CoV-2 infection and disease course, however some PLWHA and particularly males affected by ARV-related complications may be at greater risk of severe Covid-19 course.

Keywords: HIV, PLWHA, antiretroviral therapy; SARS-CoV-2; adults.

Publication types

  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • COVID-19 / epidemiology
  • COVID-19 / pathology*
  • Child
  • Comorbidity
  • Female
  • HIV Infections / epidemiology
  • HIV Infections / pathology*
  • Humans
  • Male
  • Middle Aged
  • Risk
  • SARS-CoV-2
  • Young Adult