Long COVID may be more common in people living with HIV

Simon Collins, HIV i-Base

A US paper published ahead of peer-review reported broadly similar SARS-CoV-2 specific humoral and cellular immune responses in 39 people living with and 43 closely-matched HIV negative people recovering from COVID-19, but significantly higher rates of long COVID (OR: 4.01, 95% CI: 1.45 to 11.1), p=0.008.

Participants were enrolled in the Long-term Impact of Infection with Novel Coronavirus (LIINC) COVID-19 recovery cohort at UCSF (NCT 04362150). Long COVID was defined by any symptoms present more than six weeks after diagnosis of COVID-19. Median time to assessment and severity of symptoms were similar between groups.

HIV positive participants were on effective ART with undetectable viral load. Median (IQR) CD4 count and CD4:CD8 ratios were 596 cells/mm3(IQR: 404 to 740) vs 670 cells/mm3 (IQR: 594 to 918) and 0.94 (IQR: 0.51 to 1.10) vs 2.00 (IQR: 1.52 to 2.32), in the HIV+ vs HIV– groups, respectively.

Higher proportions of PD-1 CD4 T cells and significantly higher levels of some inflammatory markers (IL-6, TNF-alpha, and IP-10) were associated with persistent symptoms.

Detailed immunological responses are also reported.


This study reported early four-fold higher risks of long COVID compared to well-matched HIV negative controls.

However, the small size makes the study unlikely to be powered to look at the HIV effect and also cautioned that the results need to be supported by larger studies.


Peluso MJ. Post-acute sequelae and adaptive immune responses in people living with HIV recovering from SARS-COV-2 infection. (14 February 2022).

Links to other websites are current at date of posting but not maintained.