"HIV and SARS-COV-2 coinfection: what is the prognosis?"
"Coinfecção HIV e SARS-COV-2: qual é o prognóstico?"
DOI:
https://doi.org/10.34119/bjhrv5n6-149Keywords:
HIV, SIDA, síndrome da imunodeficiência adquirida, COVIDAbstract
INTRODUÇÃO: A infecção por SARS-CoV-2 apresentou piores desfechos em idosos/imunocomprometidos até março/2022, causando 655.249 óbitos no Brasil. O HIV infecta linfócitos T CD4 + e os degrada, levando à imunodepressão com 37.7 milhões de infectados até 2020. Portanto, surge a hipótese de que pessoas vivendo com HIV expericiariam piores prognósticos da COVID-19 se comparados aos não-HIV. MÉTODO: Revisão sistemática horizontal com pesquisa bibliográfica realizada entre 27/março e 13/abril de 2022 nas bases de dados PubMed Central e LILACS, compreendendo artigos do período entre 2020-2022, pelo método PRISMA, para identificar artigos elegíveis que abordassem pacientes coinfectados HIV/COVID-19. Foram utilizados os termos: ‘COVID-19’, ‘HIV’, ‘AIDS’, ‘CORONAVIRUS’, ‘HUMAN IMMUNODEFICIENCY VIRUS’, ‘SARS COV 2’. RESULTADO: Encontrados 10.224 artigos e, aplicados os métodos de inclusão, restaram 30 artigos. Ao todo, foram estudados 142.790 casos de coinfecção HIV/SARS-CoV-2 de todos os continentes, sendo 95.241 (66,7%) do sexo masculino, com idade média de 51,8 anos, média de TCD4 de 558,1 e os três sintomas mais relatados da COVID-19 foram febre, tosse e dispneia. 103.765 (72,7%) pacientes estavam em terapia antirretroviral (TARV), sendo que 7 estudos não forneciam dados em relação ao número de pacientes co-infectados ou em relação ao desfecho destes. O número de óbitos foi de 7.906 (5,5%). DISCUSSÃO: A maioria dos estudos aponta que os pacientes com a coinfecção HIV/SARS-CoV-2 não apresentam maior risco de morte pela COVID-19 se comparados aos pacientes sem HIV, possivelmente por se tratar de população em tratamento com imunidade compensada. A idade média dos pacientes co-infectados foi cerca de uma década menor do que a média de idade dos pacientes internados pela COVID-19, o que pode ser justificado pelo envelhecimento precoce de pessoas vivendo com o HIV devido à inflamação crônica. A presença de comorbidades como hipertensão, diabetes e doenças cardiovasculares apresenta-se como maior fator de risco para a COVID-19 e, assim como em pacientes sem HIV, provoca maior mortalidade. CONCLUSÃO: A mortalidade pela COVID-19 em coinfectados HIV/SARS-CoV-2 não foi maior do que em pacientes sem HIV. As características e sintomas dos pacientes com coinfecção não diferiram dos pacientes não portadores de HIV. A taxa de mortalidade de pacientes co-infectados foi similar à da população em geral de 50 a 59 anos.
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