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Covid-19 Primary Care Resources

HIV: Covid risks and vaccine advice

three months

Covid risk and vaccine guidance for people living with HIV

This information is sourced from NHS Digital, AIDSThe PHE Greenbook, and the British HIV Association (BHIVA):

Covid risk in people living with HIV:

  • Patients with stable HIV and no other conditions were not specifically allocated to the shielded patient list
  • The BHIVA states that HIV alone would not be enough to put someone in the higher risk group
  • A meta-analysis published in AIDS in March 2021 concluded that emerging evidence suggests a moderately increased risk of Covid-19 mortality among people living with HIV, but that further investigation into the relationship between outcomes and CD4 count, viral load and antiretroviral treatment is warranted

Many people living with HIV have other conditions that increase their risk 

  • Almost half of people living with HIV in Europe are older than 50 years and chronic medical problems, such as cardiovascular and chronic lung disease, are more common in people living with HIV
  • BHIVA advise people living with HIV to review their QCovid risk

Covid-19 vaccines for people living with HIV:

  • Individuals who have HIV infection (regardless of CD4 count) should be given Covid-19 vaccine
  • Although AstraZeneca vaccine contains a live adenovirus vector, this virus is not replicating and is considered safe in immunosuppressed people
  • Other adenovirus vector vaccines have been trialled in populations with high prevalence of HIV and have shown no serious adverse events
  • There are ongoing studies to evaluate how protective the Covid vaccines are in people with HIV
  • Individuals with immunosuppression may not make a full immune response to vaccination
  • Vaccination of household contacts is key, particularly for anyone who has had a recent HIV-related illness, has a CD4 count less than 350 or a detectable viral load

Written by Dr Poppy Freeman


PHE: COVID-19 Greenbook chapter 14a

Published: 01/07/2021


BHIVA: COVID risk and vaccine updates

Published: 12/05/2021


AIDS: Risk of adverse coronavirus disease 2019 outcomes for people living with HIV

Published: 14/03/2021


Published: 01/04/2020