Pharmacological Considerations for the Treatment of COVID-19 in People Living with HIV (PLWH)

Overview

Journal Expert Opin Pharmacother

Publisher Informa Healthcare

Specialty Pharmacology

Date 2021 Feb 26

PMID 33634724

Citations 6

Authors

Maria Del Mar Gutierrez

Isabel Mur

Maria Gracia Mateo

Francesc Vidal

Pere Domingo

Affiliations

Soon will be listed here.

Abstract

Introduction: When coronavirus infectious disease-2019 (COVID-19) blew up, ill-fated auguries on the collision between COVID-19 and the human immunodeficiency virus (HIV) epidemics loomed.

Areas Covered: Data from observational studies suggest similar incidence attacks of SARS-CoV-2 infection in people living with HIV (PLWH) and HIV-uninfected populations. The mortality rate of COVID-19 is similar in both populations too. The authors discuss the role of combination antiretroviral therapy (cART) in preventing infection or reducing COVID-19 severity. They also discuss the pharmacological interventions for COVID-19 in PLWH.

Expert Opinion: Management of COVID-19 in PLWH is no different from the general population. It should be based on careful supportive care, emphasizing lung-protective ventilation, and wise pharmacological interventions. The antiviral drug remdesivir and dexamethasone are the only pharmacological interventions with clinical benefit for COVID-19, whereas anticoagulation may prevent thrombotic complications. The experience with using these drugs in PLWH is limited, which prevents from rendering well-founded conclusions. Until more data on COVID-19 in PLWH become available, the best weapons within our reach are sound supportive care and sensible use of RDV and dexamethasone, bearing in mind the potential for drug-drug interactions of most corticosteroids and antiretroviral drugs.

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References

Cattaneo D, Corbellino M, Galli M, Riva A, Gervasoni C, Clementi E . Does lopinavir really inhibit SARS-CoV-2?. Pharmacol Res. 2020; 158:104898. PMC: 7211645. DOI: 10.1016/j.phrs.2020.104898. View

Wu Z, McGoogan J . Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020; 323(13):1239-1242. DOI: 10.1001/jama.2020.2648. View

Loutfy M, Blatt L, Siminovitch K, Ward S, Wolff B, Lho H . Interferon alfacon-1 plus corticosteroids in severe acute respiratory syndrome: a preliminary study. JAMA. 2003; 290(24):3222-8. DOI: 10.1001/jama.290.24.3222. View

Benkovic S, Kim M, Sin E . Four cases: Human immunodeficiency virus and novel coronavirus 2019 Co-infection in patients from Long Island, New York. J Med Virol. 2020; 92(11):2338-2340. PMC: 7276853. DOI: 10.1002/jmv.26029. View

Suwanwongse K, Shabarek N . Clinical features and outcome of HIV/SARS-CoV-2 coinfected patients in The Bronx, New York city. J Med Virol. 2020; 92(11):2387-2389. PMC: 7283854. DOI: 10.1002/jmv.26077. View

Pan H, Peto R, Henao-Restrepo A, Preziosi M, Sathiyamoorthy V, Abdool Karim Q . Repurposed Antiviral Drugs for Covid-19 - Interim WHO Solidarity Trial Results. N Engl J Med. 2020; 384(6):497-511. PMC: 7727327. DOI: 10.1056/NEJMoa2023184. View

Mascolo S, Romanelli A, Carleo M, Esposito V . Could HIV infection alter the clinical course of SARS-CoV-2 infection? When less is better. J Med Virol. 2020; 92(10):1777-1778. PMC: 7262314. DOI: 10.1002/jmv.25881. View

Choy K, Wong A, Kaewpreedee P, Sia S, Chen D, Hui K . Remdesivir, lopinavir, emetine, and homoharringtonine inhibit SARS-CoV-2 replication in vitro. Antiviral Res. 2020; 178:104786. PMC: 7127386. DOI: 10.1016/j.antiviral.2020.104786. View

Cao B, Wang Y, Wen D, Liu W, Wang J, Fan G . A Trial of Lopinavir-Ritonavir in Adults Hospitalized with Severe Covid-19. N Engl J Med. 2020; 382(19):1787-1799. PMC: 7121492. DOI: 10.1056/NEJMoa2001282. View

10.

Schmitt C, Kuhn B, Zhang X, Kivitz A, Grange S . Disease-drug-drug interaction involving tocilizumab and simvastatin in patients with rheumatoid arthritis. Clin Pharmacol Ther. 2011; 89(5):735-40. DOI: 10.1038/clpt.2011.35. View

11.

Spinner C, Gottlieb R, Criner G, Lopez J, Cattelan A, Soriano Viladomiu A . Effect of Remdesivir vs Standard Care on Clinical Status at 11 Days in Patients With Moderate COVID-19: A Randomized Clinical Trial. JAMA. 2020; 324(11):1048-1057. PMC: 7442954. DOI: 10.1001/jama.2020.16349. View

12.

Webb B, Peltan I, Jensen P, Hoda D, Hunter B, Silver A . Clinical criteria for COVID-19-associated hyperinflammatory syndrome: a cohort study. Lancet Rheumatol. 2020; 2(12):e754-e763. PMC: 7524533. DOI: 10.1016/S2665-9913(20)30343-X. View

13.

Ray W, Murray K, Hall K, Arbogast P, Stein C . Azithromycin and the risk of cardiovascular death. N Engl J Med. 2012; 366(20):1881-90. PMC: 3374857. DOI: 10.1056/NEJMoa1003833. View

14.

Dauby N, Bottieau E . The unfinished story of hydroxychloroquine in COVID-19: The right anti-inflammatory dose at the right moment?. Int J Infect Dis. 2020; 103:1-2. PMC: 7567655. DOI: 10.1016/j.ijid.2020.10.032. View

15.

Tang W, Cao Z, Han M, Wang Z, Chen J, Sun W . Hydroxychloroquine in patients with mainly mild to moderate coronavirus disease 2019: open label, randomised controlled trial. BMJ. 2020; 369:m1849. PMC: 7221473. DOI: 10.1136/bmj.m1849. View

16.

Catteau L, Dauby N, Montourcy M, Bottieau E, Hautekiet J, Goetghebeur E . Low-dose hydroxychloroquine therapy and mortality in hospitalised patients with COVID-19: a nationwide observational study of 8075 participants. Int J Antimicrob Agents. 2020; 56(4):106144. PMC: 7444610. DOI: 10.1016/j.ijantimicag.2020.106144. View

17.

. Use of hydroxychloroquine in hospitalised COVID-19 patients is associated with reduced mortality: Findings from the observational multicentre Italian CORIST study. Eur J Intern Med. 2020; 82:38-47. PMC: 7446618. DOI: 10.1016/j.ejim.2020.08.019. View

18.

Dastan F, Nadji S, Saffaei A, Marjani M, Moniri A, Jamaati H . Subcutaneous administration of interferon beta-1a for COVID-19: A non-controlled prospective trial. Int Immunopharmacol. 2020; 85:106688. PMC: 7275997. DOI: 10.1016/j.intimp.2020.106688. View

19.

Ridgway J, Farley B, Benoit J, Frohne C, Hazra A, Pettit N . A Case Series of Five People Living with HIV Hospitalized with COVID-19 in Chicago, Illinois. AIDS Patient Care STDS. 2020; 34(8):331-335. PMC: 7415217. DOI: 10.1089/apc.2020.0103. View

20.

Toniati P, Piva S, Cattalini M, Garrafa E, Regola F, Castelli F . Tocilizumab for the treatment of severe COVID-19 pneumonia with hyperinflammatory syndrome and acute respiratory failure: A single center study of 100 patients in Brescia, Italy. Autoimmun Rev. 2020; 19(7):102568. PMC: 7252115. DOI: 10.1016/j.autrev.2020.102568. View