Very low-level viral load viraemia might continue after COVID-19

Simon Collins, HIV i-Base

A letter to CID reported a concern that higher HIV viral load levels might occur after HIV positive people on ART have recovered from COVID-19. However no significant differences were observed and no blips were reported above 20 copies/mL.

The results were from testing large volumes of HIV plasma using single copy viral load tests in 12 HIV positive people a median of 37 days (IQR: 29 to 62) after first COVID-19 symptoms compared to a control group of 17 HIV positive people the previous year.

Although not statistically significant, more people had detectable viral load in the COVID group: 83% vs 59%, whereas other characteristics were closely matched. The median viral load was also slightly higher: 1.59  vs 0.38 copies/mL in people with recent COVID-19 vs historical control.

Four of the COVID group had subsequent testing a median of 75 days (IQR: 58 to 90 days) with 3/4 still showing detectable viral load: median, 1.95 copies/mL (IQR: 0.1 to 14.53).

It is reassuring that the differences were small and without likely clinical significance. However, the low sample size suggest that larger studies are needed to know whether or not post-COVID viraemia might be a real effect.


Peluso MJ et al. A high percentage of people with HIV on antiretroviral therapy experience detectable low-level plasma HIV-1 RNA following COVID-19. Clinical Infectious Diseases, ciaa1754, DOI:10.1093/cid/ciaa1754. (19 November 2020).

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