Leveraging the advances in HIV for COVID-19
The COVID-19 pandemic has led to accelerated research efforts globally and highlighted the importance of community engagement and leadership in the COVID-19 response. To achieve these objectives, partnerships between science, government, and affected communities are crucial, but building these rapidly presents major challenges. In the past months, we have also seen how advances in confronting the global HIV epidemic have had a positive impact on the COVID-19 response.
Strategies used to isolate and manufacture broadly neutralising antibodies for HIV have been applied to SARS-CoV-2 and are entering clinical trials.
Although potential SARS-CoV-2 antivirals are still only in early stage research and development, eventually, combination antivirals might have a role for treatment and prevention of COVID-19, as pioneered for HIV.
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Novel vaccine platforms, including nucleic acid-based vaccines such as DNA and RNA and live vectors, again developed for HIV, are now in phase 2 and 3 clinical trials for COVID-19.
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Furthermore, given the high risk of infection and adverse outcomes from COVID-19 in Black and minority ethnic groups
and other vulnerable populations, the lessons of community empowerment and advocacy from HIV could help inform the response to COVID-19. Lessons learnt from scaling up antiretroviral therapy to more than 25 million people, including those with limited access to health care, and specifically to engage women will be applicable to rolling out any potential COVID-19 vaccines and treatments. If COVID-19 vaccines are eventually deployed, there are likely to be challenges with mass vaccination programmes but empowering marginalised groups and using a human rights approach will be central to success.
Given the scale of testing needed in the COVID-19 pandemic, the introduction of testing capabilities in LMICs could also be used for HIV and tuberculosis.
These overlapping epidemics represent an opportunity to extend cross-disciplinary research into the integrated service delivery for HIV, tuberculosis, and COVID-19, and aim to achieve sustained benefits of prevention and treatment.
Finally, the accelerated pathways to develop COVID-19 vaccines resulting in clinical trials of multiple candidates within months of discovery of SARS-CoV-2 should be applied to challenges such as developing an HIV vaccine.
Arguably, the most important lesson of the HIV response is that no country could go it alone in bringing this deadly virus to its current state of a chronic treatable condition. We need to heed this lesson to avoid nationalistic responses that jeopardise global access to solutions and cannot succeed against a global pandemic.
JHM reports that his institution had received funding to conduct clinical trials from Gilead Sciences, ViiV Healthcare, Merck Sharp & Dohme Australia. JFH reports personal fees paid to her institution from Gilead Sciences, ViiV Healthcare, and Merck Sharp & Dohme Australia. SRL reports grants from the National Health and Medical Research Council of Australia, the National Institutes of Health; American Foundation for AIDS Research, Gilead Sciences, Merck, ViiV, Leidos, the Wellcome Trust, Australian Centre for HIV and Hepatitis Virology Research, Melbourne HIV Cure Consortium, Department of Health and Human Services, and the Medical Research Future Fund. AK, L-GB, and CB declare no competing interests.
References
- 1.
Multicenter evaluation of the Cepheid Xpert Xpress SARS-CoV-2 test.
J Clin Microbiol. 2020; 128104426
- 2.
Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study.
Lancet Respir Med. 2020; 8: 475-481
- 3.
Remdesivir for the treatment of Covid-19— preliminary report.
N Engl J Med. 2020; ()
- 4.
A randomized trial of hydroxychloroquine as postexposure prophylaxis for Covid-19.
N Engl J Med. 2020; 383: 517-525
- 5.
Rapid COVID-19 vaccine development.
Science. 2020; 368: 945-946
- 6.
Safety and immunogenicity of the ChAdOx1 nCoV-19 vaccine against SARS-CoV-2: a preliminary report of a phase 1/2, single-blind, randomised controlled trial.
Lancet. 2020; 396: 467-478
- 7.
An mRNA vaccine against SARS-CoV-2—preliminary report.
N Engl J Med. 2020; ()
- 8.
COVID-19: the gendered impacts of the outbreak.
Lancet. 2020; 395: 846-848
- 9.
OpenSAFELY: factors associated with COVID-19 death in 17 million patients.
Nature. 2020; 584: 430-436
- 10.
Antibody cocktail to SARS-CoV-2 spike protein prevents rapid mutational escape seen with individual antibodies.
Science. 2020; ()
- 11.
Advancing global health and strengthening the HIV response in the era of the Sustainable Development Goals: the International AIDS Society–Lancet Commission.
Lancet. 2018; 392: 312-358
- 12.
Potential effects of disruption to HIV programmes in sub-Saharan Africa caused by COVID-19: results from multiple mathematical models.
Lancet HIV. 2020; 7: e629-e640
- 13.
Ensuring global access to COVID-19 vaccines.
Lancet. 2020; 395: 1405-1406
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Published: 03 October 2020
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