de Lazzari Elisa, Martínez-Mimbrero Alejandra, Chivite Iván, González-Cordón Ana, Mosquera Maria M, Laguno Montserrat, Costa Josep, Bosch Jordi, Blanco Jose L, Álvarez-Martinez Miriam, Ugarte Ainoa, Inciarte Alexy, de la Mora Lorena, Torres Berta, Martínez-Rebollar Maria, Ambrosioni Juan, Fernaández Emma, Hurtado Juan Carlos, Mallolas Josep, Miró José M, Marcos María A, Martínez Esteban
Department of Infectious Diseases, HIV Unit, Hospital Clinic.
Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS).
AIDS. 2022 May 1;36(6):829-838. doi: 10.1097/QAD.0000000000003164. Epub 2022 Feb 16.
To assess the impact of coronavirus disease 2019 (COVID-19) epidemics on the prevention and care for HIV and other sexually transmitted infections at a major reference centre providing preventive and clinical services in Catalonia, Spain.
We retrospectively compared anonymized clinical and laboratory data from March to December 2020 vs. 2019.
Monthly clinical data on HIV preexposure and postexposure prophylaxis users and on adults with HIV infection were retrieved from the administrative hospital database. Monthly tests for HIV, hepatitis B and C, Treponema pallidum, Neisseria gonorrhoeae,and Chlamydia trachomatis, and plasma lipids and glucose were recovered from the laboratory database.
There were less (↓28%, P = 0.003) but more advanced (mean CD4+ cells/μl 305 vs. 370, P < 0.001) HIV infections and more gonorrhoea (↑39%, P < 0.001) and chlamydia (↑37%, P < 0.001) infections in 2020 vs. 2019. In people with HIV, rates of HIV RNA less than 50 copies/ml remained stable (11 vs. 11%, P = 0.147) despite less scheduled visits (↓25%, P < 0.001). However, they had less antiretroviral prescription changes (↓10%, P = 0.018), worse plasma lipids [mean total cholesterol 190 vs. 185 mg/dl, P < 0.001;mean low-density lipoprotein (LDL) cholesterol 114 vs. 110 mg/dl, P < 0.001; mean triglycerides 136 vs. 125 mg/dl, P < 0.001; mean high-density lipoprotein (HDL) cholesterol 47 vs. 48 mg/dl, P = 006], and an excess of mortality (↑264%, P = 0.006) due in great part not only to COVID-19 but also to other causes.
In our setting, COVID-19 epidemics was associated with an increase in some prevalent sexually transmitted infections, with less but more advanced HIV infections, and with worse nonvirologic healthcare outcomes and higher mortality in people living with HIV.
评估2019冠状病毒病（COVID-19）疫情对西班牙加泰罗尼亚一家提供预防和临床服务的主要参考中心的艾滋病毒及其他性传播感染预防和护理工作的影响。
我们回顾性比较了2020年3月至12月与2019年的匿名临床和实验室数据。
从医院管理数据库中检索关于艾滋病毒暴露前和暴露后预防使用者以及成年艾滋病毒感染者的月度临床数据。从实验室数据库中获取艾滋病毒、乙型和丙型肝炎、梅毒螺旋体、淋病奈瑟菌和沙眼衣原体的月度检测结果，以及血脂和血糖数据。
与2019年相比，2020年艾滋病毒感染病例减少（下降28%，P = 0.003）但病情更严重（平均CD4+细胞/微升为305对370，P < 0.001），淋病（上升39%，P < 0.001）和衣原体感染（上升37%，P < 0.001）增多。在艾滋病毒感染者中，尽管预定就诊次数减少（下降25%，P < 0.001），但艾滋病毒RNA低于50拷贝/毫升的比例保持稳定（11%对11%，P = 0.147）。然而，他们的抗逆转录病毒药物处方变更较少（下降10%，P = 0.018），血脂情况更差[平均总胆固醇190对185毫克/分升，P < 0.001；平均低密度脂蛋白（LDL）胆固醇114对110毫克/分升，P < 0.001；平均甘油三酯136对125毫克/分升，P < 0.001；平均高密度脂蛋白（HDL）胆固醇47对48毫克/分升，P = 0.006]，并且死亡率过高（上升264%，P = 0.006），这在很大程度上不仅归因于COVID-19，还归因于其他原因。
在我们的研究环境中，COVID-19疫情与一些常见性传播感染的增加、艾滋病毒感染病例减少但病情更严重以及艾滋病毒感染者非病毒学医疗结局更差和死亡率更高有关。
