Covid-19: in South Africa, the hunt for variants to the challenge of the fight against HIV

As South Africa has officially entered a fourth wave that is advancing at a rapid pace ” never seen “ According to the authorities, HIV-positive patients are canceling their follow-up consultations again, as they have done in each wave since the start of the Covid-19 pandemic. “In the clinics we work with, the number of people diagnosed with HIV has been cut in half. The number of patients under treatment has also decreased and the number of people who do not come to consultations is increasing ”, explains Dr Moyahabo Mabitsi, executive director of the South African organization Anova, which supports the government in HIV testing and treatment in more than 500 clinics.

With nearly eight million people living with HIV, South Africa is the primary focus of the HIV epidemic in the world. While nearly five million of them are effectively monitored and have an undetectable viral load, at least two million are not on treatment and it is feared that the figure is underestimated as the number of screening tests has plummeted. by almost half and that the number of patients starting antiretroviral therapy fell by more than a third between 2019 and 2020 as a result of the pandemic.

Read also HIV testing and prevention: Covid-19 has ruined the progress made in recent years

In a column published on December 2 in the journal Nature, four South African scientists, including two members of the team behind the discovery of the Omicron and Beta variants, question the international community on the risk that this break in the pandemic could pose to the evolution of the pandemic. access to care for people living with HIV: “Failure to fight the pandemic at the height of the emergency in countries with high rates of people infected with advanced HIV and insufficiently treated could lead to the emergence of variants of the coronavirus SARS-CoV-2 more transmissible or making less effective vaccines. “

The hypothesis of prolonged infection in immunocompromised

A carefully balanced statement to communicate on one of the most sensitive hypotheses on the sudden emergence of highly mutated variants. Prolonged infection with the SARS-CoV-2 coronavirus in people immunocompromised both due to cancer chemotherapy treatment and HIV infection could be involved in the emergence of the Alpha variant, discovered in the United Kingdom in November 2020, of the Beta variant discovered in South Africa in October 2020, of the Gamma variant, discovered in Manaus, Brazil, in January 2021, and now, of the Omicron variant.

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Covid-19: in South Africa, the hunt for variants to the challenge of the fight against HIV