Vaccination against COVID-19 for people with HIV

A las personas seropositivas, las vacunas contra la COVID-19 les aportan los mismos beneficios que al resto de los individuos y comunidades. Es la postura oficial de ONU Sida. Por un lado, ayudan a prevenir los casos graves de infección por el virus SARS-CoV-2 y, por otro, reducen potencialmente la transmisión.

Vaccine and virus specialists recommend saving calm and discarding false information.Some groups of patients are afraid of vaccinating due to lack of official information;They are not clear whether or not they should do it.

“Un gran grupo de pacientes nos ha contactado para hablar un poco sobre el uso de las vacunas del COVID-19 en pacientes con VIH”, comenta el doctor Pablo Torres Córdova, alergólogo e inmunólogo.

HIV can produce a secondary immunodeficiency state, progressively weakening immune system defenses.In general, defense mechanisms against microorganisms such as viruses, bacteria or fungi are called immunoglobulins or antibodies, and various types of cells such as lymphocytes."When someone is infected with HIV, it is more susceptible to the lymphocyte defense arm is more weakened, since that is where the virus is housed and replicated," adds the doctor.

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In a weakened immune system, which predisposes to suffer from potentially serious infections, and in the context of a worldwide pandemic, what to do?Can this group of patients with HIV be freely vaccinate?

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According to Torres, the answer is yes. “Estos pacientes deben estar controlados de su enfermedad, usando sus medicamentos retrovirales adecuadamente y siempre bajo el seguimiento de su médico especialista, para así minimizar el riesgo de infecciones”.People with HIV with low CD4 count or who are not using HIV medications properly have a higher risk of seriously ill from COVID-19.

El doctor Alejandro Rivas, internista e infectólogo, explica que los diferentes estudios en personas con VIH permiten saber que las personas portadoras de ese virus que tienen más de 250 células CD4 por milímetro cúbico, o más, pueden vacunarse con tranquilidad. “No habrá ningún problema y producirán la misma respuesta inmune que una persona con inmunidad normal”.

This requirement is because CD4 lymphocytes act against the HIV virus and also against the coronavirus, so if they have to fight both, it is easy for immunity to be reduced, and other opportunistic viruses and bacteria cause additional infections. Lo ideal, dice Rivas, es tener una carga viral indetectable.

Is there interaction between the COVID-19 vaccine and the retrovirals?

Las vacunas para el COVID-19 son seguras para estos pacientes, “especialmente las vacunas de Pfizer, AstraZeneca y Johnson & Johnson”, asegura Torres, “ya que no son vacunas vivas y apenas incluyen dentro de ellas material genético del virus SARS-CoV-2 que no puede replicarse, es decir, no se desarrollaría el virus y no se produciría la enfermedad”.That makes them safe both for patients with an immunodeficent system and for immunocompetent people.

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Otra cosa, no hay interacciones entre los medicamentos del VIH con las vacunas del COVID-19, por este motivo, no se debe suspender el tratamiento antirretroviral ni dejar de vacunarse solamente porque esté en vigencia el tratamiento de la enfermedad de base.

“Theoretically, it is possible that people with HIV could have a lower immune response to vaccines, that is, they would not be so effective when compared to the effect on people without HIV.But there is no evidence yet on this issue, ”emphasizes towers, so it is very importantMasks and social distancing.

Are there contraindications to vaccinate against COVID-19 if you have HIV?

Como en otras enfermedades, las únicas contraindicaciones serían cuadros febriles sin diagnóstico, COVID-19 asintomático, reacciones anafilácticas graves.

El doctor Rivas observa que si bien no se ha demostrado de manera exhaustiva, los retrovirales incluso podrían tener un leve efecto en que el coronavirus no actúe de forma tan cruel con los pacientes con VIH."An observation: from March to July 2020, I barely had a patient with COVID-19," he says.There were more cases in the second wave, "but of them, none had serious complications or death".And those who have been vaccinated, since then, have had the same reactions as any other person, light and temporary discomfort.(YO)