Within half a century, the world has experienced two elusive and deadly viral diseases responsible for pandemics. While there are many similarities between the ongoing HIV pandemic and the current pandemic resulting from SARS-CoV-2 infection, there are also noticeable differences.
In this article, we discuss the SARS-CoV-2 and HIV viruses, the similarities and differences of the illnesses and their pandemics, and future outlooks.
HIV attacks a person’s immune system, rendering their bodies unable to fight off illnesses. Left untreated, a person with HIV can develop AIDS. This refers to the final phase of HIV infection, where damage to the immune system is so severe that it results in an increasing number of opportunistic infections.
Coronavirus disease 2019 (COVID-19) is an infection caused by a novel strain of coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). People with COVID-19 can develop mild to very severe respiratory illness and a number of other possible symptoms.
HIV is a Lentivirus, which is a genus of retroviruses. These types of viruses are known to have long incubation periods that can cause chronic and deadly diseases. HIV has two types, HIV-1 and HIV-2. Learn more about their differences here.
HIV attacks the immune system by infecting immune cells called CD4 cells. After infecting these immune cells, HIV uses it to produce copies of itself then kills the CD4 cells, which weakens the immune system. HIV spreads through the exchange of various bodily fluids, such as blood, semen, and vaginal fluids.
SARS-CoV-2 is a virus that comes from a large family of viruses called coronavirus that have characteristic crown-like projections on their surfaces. Other notable coronaviruses include severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV).
While illness due to SARS-CoV-2 may often be mild to moderate, in some cases people can become seriously ill. In this situation, the body produces an intense immune response after detecting the virus, which can result in damage to the lungs and other vital organs.
During the early days of both pandemics, aside from shock, most of the world’s governments responded with denial, downplaying, delayed responses, and neglect. Both pandemics have instilled great fear in the population, caused disruption of everyday life, and led to the deaths of many people.
Another similarity is the necessity of public compliance. With COVID-19, containing the SARS-CoV-2 virus largely depends on people following guidance and protocols, such as physical distancing, using face coverings, maintaining hygiene, performing contact tracing, and monitoring.
Similarly, people with HIV, or those who suspect exposure to the virus, test for an infection and receive treatment to lower their viral load to reduce symptoms and the risk of transmission. Behaviors such as proper condom use and not sharing needles can also reduce transmission.
Additionally, both viruses are examples of zoonosis, as they have animal origins and are now capable of infecting humans. Furthermore, most research also suggests that both viruses became transmissible to humans following the consumption of animals with the original infection.
A significant difference between the two pandemics is their timelines. While positive cases and deaths from HIV and AIDS continue worldwide, the spread of HIV since its discovery in the 1980s is slow compared with COVID-19’s millions of cases since its recognition in late 2019.
Public health has largely managed to contain COVID-19 within several months through rigorous testing, contact tracing, and stringent health measures. Meanwhile, despite the world adopting the World Health Organization’s (WHO) strategic guidelines to control the disease, the HIV pandemic remains a major global health issue.
Also, while there are already several successful vaccines that can provide sufficient immunity against COVID-19, there is still no success in creating a vaccine for HIV or AIDS.
Both viruses can spread from people who unknowingly have the infection but present with no symptoms. However, while HIV is most contagious during its acute phase, it remains contagious in people not receiving any treatment.
In comparison, the Centers for Disease Control and Prevention (CDC) state that following possible exposure to SARS-CoV-2, people are likely to only be contagious for 14 days and can be around others 10 days after they first developed symptoms if testing negative or symptoms are improving.
One stark difference between the two viruses is that SARS-CoV-2 is very easily transmittable due to it being an airborne infection, whereas HIV transmission relies on contact with infected bodily fluids. Furthermore, people may develop symptoms of COVID-19 2–14 days after exposure to the virus, while it typically takes 2–4 weeks after infection for people to present with primary symptoms of HIV.
Based on the WHO’s coronavirus (COVID-19) dashboard, there have been over 200 million confirmed COVID-19 cases, including over 4 million deaths due to the disease. Meanwhile, since the beginning of the HIV pandemic, there has been almost 80 million cases of HIV infection. Of these, nearly 37 million people have died from AIDS-related illnesses.
Notably, a 2021 study mentions that more than 95% of people with HIV who do not receive treatment die, while only 1–4% of people with COVID-19 who do not receive treatment die.
There are currently no effective cures for the illnesses caused by either virus. However, treatments to reduce symptom severity and prevent or reduce the risk of transmission exist.
In some cases, people may be able to manage and relieve mild symptoms of COVID-19 at home. For more severe cases that require hospitalization, the Food and Drug Administration (FDA) has approved Remdesivir (Vekclury) and has issued Emergency Use Authorization for several monoclonal antibodies.
The CDC recommends the following to protect individuals and others from getting COVID-19:
- physical distancing
- wearing masks or face coverings
- proper and constant hand washing
- avoiding crowded and poorly ventilated places
- proper hygiene
Additionally, many safe and effective vaccines for COVID-19 are available. These vaccines can reduce the transmission of SARS-CoV-2 and can prevent a person from becoming seriously ill if they develop COVID-19.
Individuals with HIV receive antiretroviral therapies (ART), which are treatment regimens consisting of two or more drugs that suppress the virus from replicating. This can help a person to reduce their viral load to such an extent that it is undetectable. This means that a person can no longer transmit the virus to another person, helping them to live a full, healthy life.
Preventive measures are still in place to prevent the spread of both viruses. The CDC recommends the following preventive strategies for HIV:
- modifying sexual practices, including abstinence or condom use
- no needle sharing
- use of pre-exposure prophylaxis (PrEP)
- use of post-exposure prophylaxis (PEP)
COVID-19 vaccine rollouts are continuing across the globe, aiming to reach herd immunity as soon as possible. Based on Our World in Data, roughly 29% of the world population have received at least one dose of a COVID-19 vaccine, and approximately 15% of the population are fully vaccinated.
However, there is still a disparity between wealthy and low income countries when it comes to COVID-19 vaccination efforts. Currently, only 1.1% of people in low income countries have received at least one dose of a COVID-19 vaccine.
Currently, there are three vaccines available in the United States, and more have received approval for full use globally. Scientists are continuing their research on developing new and more effective vaccines.
Meanwhile, due to the nature of HIV, it is more difficult to develop an effective vaccine. However, research is ongoing. Currently, research efforts include two late-stage, multinational vaccine clinical trials called Imbokodo and Mosaico.
Additionally, researchers are working on developing broadly neutralizing antibodies (bNabs), which may be able to stop a wide range of HIV strains. A 2020 study suggests the potential of using adeno-associated viruses and monkeys to produce monoclonal antibodies that may offer lifelong protection against HIV.
COVID-19 and HIV are diseases caused by two contagious viruses that are responsible for global pandemics. The viruses share certain similarities like their origin, but they also have stark differences in their symptoms, mode of transmission, and disease course.
Due to these differences, public health measures vary in the preventive measures they employ. At present, there are no vaccines against HIV, but treatment options exist that can help manage the condition. As for COVID-19, safe and effective vaccines are available that can reduce viral transmission and symptom severity.