Two Serial Case of Coronavirus Disease-19 Patients Coinfected with HIV: Comparison of Pre-anti-Retroviral (art) and on Art Patient

Abstract

BACKGROUND: Today, coronavirus disease (COVID)-19 has become a worldwide pandemic. People living with HIV are one of the special populations who are susceptible to COVID-19 infection and suspected of having a poor prognosis.

CASE REPORT: We reported two serial cases of COVID-19 with HIV coinfection. First case was a COVID-19 patient coinfected with HIV who had received anti-retroviral therapy (ARV) and had an absolute CD4 cell count of 781 cells/uL. Patient was found with mild symptoms of COVID-19 and had normal laboratory results and chest X-ray. Patient was declared cured after 26 days of treatment in isolation room with complete clinical improvement since day 5 of isolation. Second case was a COVID-19 with HIV coinfection that had not yet received ARV therapy and had absolute CD4 cell count of 155 Cell/uL. Patient came with moderate clinical symptom of COVID-19 and experienced secondary bacterial and tuberculosis infection. Patient was declared cured of COVID-19 on the 8th day of treatment with clinical improvement but still needed further treatment in a non-isolation room.

CONCLUSION: Clinical characteristics of COVID-19 in HIV and non-HIV patients are the same. A history of ARV therapy and CD4 count did not affect the length of isolation until a negative result on two reverse-transcription-polymerase chain reactions, but could affect prognosis and clinical severity due to the high risk of secondary infection in HIV-positive patients without ARV or HIV/AIDS who had a CD4 count ≤200 cell/uL.