Omicron: What’s the link between HIV and new Covid-19 variant?

As more HIV positive people stopped their antiretroviral treatment this year, their immune system became more vulnerable. Scientists think this might have contributed to the mutation of Covid-19, including the latest Omicron variant.

With 13.7% of South Africans being HIV positive, a large proportion of the population is susceptible to Covid-19 infections due to HIV targeting the immune system.

Making this situation worse is that 4% of the 8.2 million HIV infected people were off their antiretroviral medication this year, according to Statistics SA.

This means 328,000 HIV positive patients are not taking their medication, which has proven to reduce the HIV mortality rate, said StatsSA.

With the new Omicron variant emerging and quickly spreading across the world, there was speculation that this evolution of the Covid-19 virus was from an untreated HIV patient.

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While this was not proven, Professor Francois Balloux, Director of the UCL Genetics Institute, said because of the large number of mutations in the Omicron variant, it likely evolved from an immunocompromised and untreated HIV/Aids patient.

“Given the large number of mutations it has accumulated apparently in a single burst, it likely evolved during a chronic infection of an immunocompromised person, possibly in an untreated HIV/Aids patient,” he said.

But Botswana, where it was initially claimed the variant emerged from, dismissed such allegations. The country’s presidential task force said there was no link between HIV status and Covid infections.

Why the speculation?

Since the HIV virus targets a person’s immune system, any bacteria or virus, such as the flu, remain in the system longer.

While this applied to other immunocompromised persons such as cancer patients undergoing chemotherapy, diabetic patients and those with liver disease, HIV was the most common, said Stellenbosch University epidemiologist Dr Jo Barnes.

Due to the immune system’s weakness, the virus or bacteria starts to replicate in the person’s body, Barnes said. This gives the virus a chance to mutate.

“For people with a damaged immune system, the virus will replicate and replicate for weeks in the body because the immune system can’t eliminate it. Every time it replicates, there is a chance that some little piece of the mechanism changes a bit. The more and more generations of the virus are inside that same body, the higher the chances that little bits and pieces keep on changing.”

HIV treatment declining

Despite ARV treatment declining by 4% this year, South Africa has the largest ARV treatment programme in the world. According to UNAIDS 2019 fact sheet, the most recent figures, 71% of HIV positive patients were on treatment.

But this meant that HIV infected people who were not treated were a “depository for multiplying the organism and depositing it back into the world”.

“It is urgent that we put all our HIV positive patients on treatment because a frightening number of them don’t stay on treatment and the pandemic has been a big worry for us because people couldn’t access their medication,” said Barnes.

According to Stats SA, the supply of medication for HIV treatment was hampered by the pandemic and the associated lockdown and travel restrictions.

“Those who are on treatment, their immune system should not be far from normal. It is the ones who are not treated that are an issue and it’s a worrisome number of them,” said Barnes.

rorisangk@citizen.co.za

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