December 01, 2020
What makes HIV different from COVID-19? And why there is no HIV vaccine yet? Julio Cachay, Internist at our clinic and an HIV specialist, helps us answer these questions.
40 years ago, the world experienced a pandemic due to the spread of the human immunodeficiency virus (HIV), which causes Acquired Immune Deficiency Syndrome (AIDS), the critical stage of the disease.
This year, after four decades, the SARS CoV-2 virus led the world to face a pandemic of great magnitude. One of the main differences between the two pandemics is that there was no diagnostic test for HIV until 3 years after the first cases were reported. With the new coronavirus, diagnostic tests (such as PCR molecular) were available during the first three months of 2020, which helped identify virus carriers and try to flatten the contagion curve.
Dr. Cachay emphasizes that the “form of presentation (spread in the five continents) gives rise to similarity with COVID-19.”
“Another similarity between these two pandemics is that the etiological agent is a virus: HIV generates AIDS, and the SARS CoV-2 virus generates COVID-19. An additional similarity between these pandemics is the potential lethality with which the infection of both ends.”
However, Dr. Cachay says that their differences are more noticeable than their possible similarities in the evolution of the infection, the transmission mechanisms, and the treatment used.
“AIDS is an infection with a chronic lifelong course and COVID-19 is an acute infection that resolves in weeks. The transmission mechanisms are also different: HIV is transmitted by direct sexual contact and COVID-19 by direct contact but through respiratory droplets. While for HIV/AIDS infection exists an antiretroviral treatment that controls the infection and prevents high mortality, for COVID-19 we still do not have specific antiviral management.”
The doctor also highlights that in the case of HIV/AIDS, so far, there is no effective vaccine, due to the characteristics of the virus. “It has a great capacity to mutate and change its genome, which determines that in a year this virus has changed, it has mutated its protein coat by 30 to 40%, protecting the virus, so to speak, from immune mechanisms.”
“Unlike SARS CoV-2, a vaccine has been obtained with an effectiveness of 90% or more generating an immune response through specific antibodies against SARS CoV-2, neutralizing, and protecting the person. Again, this is because the SARS COv-2 virus, which produces COVID-19, is a relatively more stable virus than HIV, the AIDS virus”, he adds.
Although scientific advances about COVID-19 have been auspicious, we must bear in mind that we will not be able to return to the “normality” we used to have before the COVID-19 pandemic. As with HIV, the world will have to learn to live alongside the new coronavirus, even with effective treatment and a safe vaccine, mainly due to problems of access to universal health.
Our specialist says that like any infection transmitted to humans after an epidemic behavior comes the endemic phase. That is, new cases persist, but much less frequently over months or years.
“In this context, the prevention mechanisms for COVID-19 produced by SARS CoV-2, which is transmitted directly from person to person through respiratory droplets, are well known: the continuous and universal use of masks, social distancing of 2 meters, washing hands with soap and water for 20 seconds regularly, avoiding crowds of people and, also, favoring the ventilation of environments or staying in open spaces. All these measures will reduce the possibility of transmission risk of SARS CoV-2 and, therefore, we must take them as a normal standard in our daily lives”, he concludes.
Dr. Julio Cachay
Internist and Infectious Diseases Specialist at Clínica Ricardo Palma