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      The syndemic burden of HIV/AIDS in Africa amidst the COVID‐19 pandemic

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          Abstract

          Introduction: The human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) has long affected millions of individuals across the globe. Historically, the prevalence of this disease is particularly noted within the African continent. Before the coronavirus disease 2019 (COVID‐19) pandemic, many African countries struggled to effectively manage the increasing burden associated with HIV/AIDS. There is now a need to reassess this in a COVID‐19 pandemic context so that the impact of COVID‐19 on HIV/AIDS healthcare within Africa can be adequately evaluated.

          Methods: Data collection was performed on the PubMed, Ovid MEDLINE and Embase bibliographical databases with a predefined search strategy. Searches were performed in blind duplicate and all articles considering COVID‐19 and HIV/AIDS within African healthcare were considered.

          Results: The COVID‐19 pandemic has severely exacerbated the many issues surrounding HIV/AIDS care within many African countries. These impacts are noticeable in medical, psychological, and socio‐political contexts.

          Conclusions: Before efforts are made to improve the provision of HIV/AIDS and COVID‐19 care within Africa, it is important that this issue is brought to the attention of the scientific and clinical community so that the continent can receive the necessary support and aid.

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          Coronavirus infections and immune responses

          Geng Li, Yaohua Fan, Yanni Lai … (2020)
          Abstract Coronaviruses (CoVs) are by far the largest group of known positive‐sense RNA viruses having an extensive range of natural hosts. In the past few decades, newly evolved Coronaviruses have posed a global threat to public health. The immune response is essential to control and eliminate CoV infections, however, maladjusted immune responses may result in immunopathology and impaired pulmonary gas exchange. Gaining a deeper understanding of the interaction between Coronaviruses and the innate immune systems of the hosts may shed light on the development and persistence of inflammation in the lungs and hopefully can reduce the risk of lung inflammation caused by CoVs. In this review, we provide an update on CoV infections and relevant diseases, particularly the host defense against CoV‐induced inflammation of lung tissue, as well as the role of the innate immune system in the pathogenesis and clinical treatment.
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            Potential effects of disruption to HIV programmes in sub-Saharan Africa caused by COVID-19: results from multiple mathematical models

            Britta Jewell, Edinah Mudimu, John Stover … (2020)
            Summary Background The COVID-19 pandemic could lead to disruptions to provision of HIV services for people living with HIV and those at risk of acquiring HIV in sub-Saharan Africa, where UNAIDS estimated that more than two-thirds of the approximately 38 million people living with HIV resided in 2018. We aimed to predict the potential effects of such disruptions on HIV-related deaths and new infections in sub-Saharan Africa. Methods In this modelling study, we used five well described models of HIV epidemics (Goals, Optima HIV, HIV Synthesis, an Imperial College London model, and Epidemiological MODeling software [EMOD]) to estimate the effect of various potential disruptions to HIV prevention, testing, and treatment services on HIV-related deaths and new infections in sub-Saharan Africa lasting 6 months over 1 year from April 1, 2020. We considered scenarios in which disruptions affected 20%, 50%, and 100% of the population. Findings A 6-month interruption of supply of antiretroviral therapy (ART) drugs across 50% of the population of people living with HIV who are on treatment would be expected to lead to a 1·63 times (median across models; range 1·39–1·87) increase in HIV-related deaths over a 1-year period compared with no disruption. In sub-Saharan Africa, this increase amounts to a median excess of HIV deaths, across all model estimates, of 296 000 (range 229 023–420 000) if such a high level of disruption occurred. Interruption of ART would increase mother-to-child transmission of HIV by approximately 1·6 times. Although an interruption in the supply of ART drugs would have the largest impact of any potential disruptions, effects of poorer clinical care due to overstretched health facilities, interruptions of supply of other drugs such as co-trimoxazole, and suspension of HIV testing would all have a substantial effect on population-level mortality (up to a 1·06 times increase in HIV-related deaths over a 1-year period due to disruptions affecting 50% of the population compared with no disruption). Interruption to condom supplies and peer education would make populations more susceptible to increases in HIV incidence, although physical distancing measures could lead to reductions in risky sexual behaviour (up to 1·19 times increase in new HIV infections over a 1-year period if 50% of people are affected). Interpretation During the COVID-19 pandemic, the primary priority for governments, donors, suppliers, and communities should focus on maintaining uninterrupted supply of ART drugs for people with HIV to avoid additional HIV-related deaths. The provision of other HIV prevention measures is also important to prevent any increase in HIV incidence. Funding Bill & Melinda Gates Foundation.
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              COVID-19 Outcomes Among Persons Living With or Without Diagnosed HIV Infection in New York State

              James Tesoriero, Carol-Ann E Swain, Jennifer Pierce … (2021)
              Key Points Question Is there an association between prior diagnosis of HIV infection and coronavirus disease 2019 (COVID-19) diagnosis, hospitalization, and in-hospital death among residents of New York State? Findings In a cohort study of linked statewide HIV diagnosis, COVID-19 laboratory diagnosis, and hospitalization databases, persons living with an HIV diagnosis were more likely to receive a diagnosis of, be hospitalized with, and die in-hospital with COVID-19 compared with those not living with an HIV diagnosis. After demographic adjustment, COVID-19 hospitalization remained significantly elevated for individuals with an HIV diagnosis and was associated with elevated mortality. Meaning Persons living with an HIV diagnosis experienced poorer COVID-related outcomes (principally, higher rates of severe disease requiring hospitalization) relative to those without an HIV diagnosis.
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                Author and article information

                Contributors
                Olivier Uwishema:
                ORCID: http://orcid.org/0000-0002-0692-9027
                uwolivier1@ktu.edu.tr
                Journal
                Journal ID (nlm-ta): Immun Inflamm Dis
                Journal ID (iso-abbrev): Immun Inflamm Dis
                Journal ID (doi): 10.1002/(ISSN)2050-4527
                Journal ID (publisher-id): IID3
                Title: Immunity, Inflammation and Disease
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Electronic): 2050-4527
                Publication date (Electronic): 04 October 2021
                Publication date PMC-release: 04 October 2021
                Electronic Location Identifier: 10.1002/iid3.544
                Affiliations
                [ 1 ] Oli Health Magazine Organization Research and Education Kigali Rwanda
                [ 2 ] Clinton Global Initiative University New York New York USA
                [ 3 ] Faculty of Medicine Karadeniz Technical University Trabzon Turkey
                [ 4 ] Faculty of Medicine University of Southampton Southampton UK
                [ 5 ] Department of Medicine, College of Health Sciences University of Ilorin Ilorin Kwara State Nigeria
                [ 6 ] Department of Nursing and Midwifery, Faculty of Health Sciences Lira University Lira Uganda
                [ 7 ] Faculty of Medicine University of Saint Joseph of Beirut Beirut Lebanon
                [ 8 ] Faculty of Health Sciences McMaster University Hamilton Ontario Canada
                [ 9 ] Medical Laboratory Technologist The Mombasa Hospital Mombasa Kenya
                [ 10 ] School of Chemical Engineering University of Birmingham Edgbaston, Birmingham UK
                Author notes
                [*] [* ] Correspondence Olivier Uwishema, Faculty of Medicine, Karadeniz Technical University, Trabzon 61080, Turkey.

                Email: uwolivier1@ 123456ktu.edu.tr

                Author information
                http://orcid.org/0000-0002-0692-9027
                http://orcid.org/0000-0002-1386-5244
                Article
                Publisher ID: IID3544
                DOI: 10.1002/iid3.544
                PMC ID: 8652687
                PubMed ID: 34606689
                SO-VID: e3522e7d-deef-4ddd-ba98-33f2f71d9a6a
                Copyright © © 2021 The Authors. Immunity, Inflammation and Disease published by John Wiley & Sons Ltd.
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                Date revision received : 22 September 2021
                Date received : 06 July 2021
                Date accepted : 26 September 2021
                Page count
                Figures: 0, Tables: 0, Pages: 7, Words: 4081
                Categories
                Subject: Commentary
                Subject: Commentary
                Custom metadata
                source-schema-version-number 2.0
                edited-state corrected-proof
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.9 mode:remove_FC converted:08.12.2021

                Keywords: acquired immune deficiency syndrome,africa,antiretroviral therapy,coronavirus,covid‐19,hiv/aids,human immunodeficiency virus
                Data availability:
                Keywords: acquired immune deficiency syndrome, africa, antiretroviral therapy, coronavirus, covid‐19, hiv/aids, human immunodeficiency virus

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