The team led by Dr. Steve Nguala from the Villeneuve-Saint-Georges intercommunal hospital center conducted this preliminary observational study with more than 500 people living with HIV. Findings reveal an association between protease inhibitor (PI) ART and a 70% reduced risk of COVID-19 infection. This encouraging and promising discovery will have to be validated by larger studies: the researchers specify that “these conclusions should not be considered as conclusive proof that the long-term use of protease inhibitors protects people living with HIV. of COVID-19”.
On the positive role of protease inhibitors once morest viral replication
Suggestions for other protective effects of ART: people living with HIV are at higher risk of community-acquired or opportunistic infections, but, surprisingly, do not appear to be at increased risk of severe COVID-19. This finding prompts the hypothesis that their ART might have a protective effect once morest COVID-19. The researchers also recall that ART was documented as a possible protective factor once morest Severe Acute Respiratory Syndrome (SARS) in 2003, but on too small a sample of patients to be able to conclude.
Protease inhibitors, a class of antiviral drugs used to treat HIV, work by blocking an essential enzyme (called a protease) that viruses need to replicate and infect more cells. The effectiveness of these drugs once morest COVID-19 has never been studied. This is why the French team conducted this multicenter cohort study in 6 hospitals in Ile-de-France to assess the impact of the long-term use of PIs in HIV-positive patients, on the incidence of COVID. -19. The study therefore followed, from May 2020 to May 2021, 169 HIV-positive participants treated with ART with PI and 338 HIV-positive patients treated with ART without PI. The average age of the participants was 50 years old. None of the participants had previously been diagnosed with COVID-19. All patients underwent regular clinical assessments and screening for COVID-19 during routine HIV follow-up (every 6 months). The analysis reveals, over 1 year of follow-up, that:
- 12% (18/153) of participants taking PIs vs 22% (61/283) of participants in the “non-PI” group contracted COVID-19 assessed by positive SARS-COV-2 serology at the end of the study ;
- 4 patients in the non-PI group were hospitalized with COVID-19;
- After accounting for possible confounders (or increased risk factors for COVID-19), patients in the PI group have a 70% reduced risk of COVID-19 infection than participants in the non-PI group.
“Protease inhibitor drugs have a long history of use. The reduced incidence of COVID-19 in patients treated with these drugs raises the question of a preventive effect that needs to be further investigated. Further studies with larger numbers of patients and randomized trials in people without HIV are needed to confirm these promising preliminary results.”
Note, Paxlovid, developed by Pfizer, once morest severe forms of COVID-19, is a combination of 2 molecules, including a major protease inhibitor of SARS-CoV-2.
