So far, the results don’t seem to have been feared

based on Official figure— This may be a little underreported — COVID-19 was not as devastating as it was first feared in South Africa.

Back in March and April of this year Case number It was still modest on the continent. But Forecast and forecast It was solemn. There seems to be a consensus that African countries are weak Public health system And a few Test equipment, And containment and social distance were issues Poor community..

More specifically, regional and international organizations Pointed out the facts Individuals with immunodeficiency usually have the highest incidence in these areas. Expert Afraid Tens of millions of people with HIV and tuberculosis will be disproportionately affected by COVID-19.

That was not a good omen for South Africa. 7 million people It is believed to be infected with HIV. The immune system of these individuals Notorious, Often unable to fight infection. COVID-19 is Catastrophic To this community.

Those misery forecast So far, it hasn’t happened. About half of the cases of COVID-19 on the continent were from South Africa. country’s COVID-19 case As of mid-September, it was about 653,400. About 15,705 people Estimate He died of COVID-19. It’s a tragic number, but not as many as some predicted. early Forecast There are more than 1 million symptomatic cases of COVID-19 in South Africa by July, with the potential for 30,000 deaths by November 2020.

These relatively “low” numbers have come as a surprise. Many possibilities Commentary An outbreak has emerged from this modest comparison.

Some insights into previous outbreaks of human coronavirus may be useful in this regard. My laboratory Recently reviewed What is known at this stage and what is still unknown about the co-infection of HIV and coronavirus.

Human coronavirus

Currently, there are seven known human coronaviruses.

Of these, the four most common and still in circulation Has been reported Causes about 10% to 30% of common colds worldwide. Fortunately, according to research Symptoms of mild to moderate cold.. In rare cases, these human coronaviruses can cause more serious respiratory illness in immunocompromised children and the elderly, including people with HIV and underlying illness. However, as far as we know, death as a result of infection with the “common” human coronavirus Very rare..

Then there are three more pathogenic or life-threatening coronaviruses. Of these, the first to appear in humans Severe acute respiratory syndrome coronavirus (SARS-CoV), this is Severe acute respiratory syndrome, Or SARS killed about 10% of just over 8,000 infected people.

next Middle East Respiratory Syndrome Coronavirus (MERS-CoV) causes Middle East Respiratory Syndrome (MERS), which kills an estimated 34% of about 2,494 people known to be infected.

And now Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), the virus behind COVID-19.

SARS-CoV-2 has been found to have several factors associated with serious illness and death. These include the elderly. Being a man; and other beings Existing medical condition Includes obesity, diabetes, heart disease, lung disease and kidney disease. This does not mean that young people and women are not affected by the disease. They can catch the virus and pass it on to others.

Of particular interest in South Africa is the risk of co-infection with COVID-19 and HIV.

Interaction between HIV and CoV

Prior to the pandemic of COVID-19, no academic research on co-infection with HIV and coronavirus was published. This is one of the reasons why the horrific movement of COVID-19 has increased anxiety levels in countries with large numbers of people living with HIV, such as South Africa. Especially in the late 1980s, the coronavirus Opportunistic infections in immunocompromised hosts, Was linked to diarrheal disease among AIDS patients.

But otherwise, there was little known association between HIV and the coronavirus. I know only one case reported HIV-positive people infected with SARS in 2003 Outbreak. This person has fully recovered from SARS.

At the same time Another study reported on the relationship between HIV and SARS.. In this case, 19 HIV-positive patients shared an in-hospital ward and 95 patients were confirmed to be SARS-positive. For some reason, none of the HIV-positive patients were infected with SARS-CoV. Six of the 28 medical personnel working in the ward were infected. At that time, researchers began to speculate that antiretroviral treatment provided some protection against SARS-CoV in HIV patients. However, this was not clearly established as SARS-CoV disappeared rapidly from the human population.

The COVID-19 pandemic is driving research into co-infection with the HIV coronavirus.

My laboratory Summary of recently published studies We examined more than 11,000 HIV-positive individuals for COVID-19 infection. The risks associated with superinfection are still controversial. However, the estimated COVID-19 prevalence reported in various studies does not suggest an increase in hospitalization or mortality in the HIV-positive population. The clinical features and disease outcomes were similar to those described in the general population of COVID-19.

The reasons for these infections and mortality are still unknown. But scientists have come up with some interesting hypotheses.

One is antiretroviral treatment Anti-CoV property Provides some protection against COVID-19 infection. another Weakened immune system in people infected with HIV prevents the “overreaction” of HIV Coronavirus.. In this way, it prevents the increase in inflammation associated with COVID-19. Relation argument Helper T cells are inactivated in HIV-positive patients, which suppresses the immune system’s response and limits the risk of excessive inflammation.

More interesting hypothesis Suggest Original HIV infection It alters the host cell and no longer provides a favorable environment for other viruses. This phenomenon is called “virus interference”. And it was Insisted Some cold-causing viruses blocked at least one flu pandemic in Europe in 2009.

Advance

Concerns about HIV-positive patients are understandable. However, current data from the COVID-19 pandemic and past experience with SARS and MERS suggest that they are not forming a risky group. This raises the question of whether HIV acts as an immunological shield against the more serious forms of new diseases.

What was pretty obvious from the beginning was that old age Comorbidity Obesity, hypertension, diabetes, etc. are issues to consider for both common infections and HIV / SARS-CoV-2 co-infections.

Based on what is currently known, when the second or third wave of COVID-19 arrives, state and health authorities need to consider a more strategic and targeted approach to containment.

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