Hazell George A, Nott Veronica R, Ayres Sara, Frize Graham, Kirkhope Natalie, Fidler Sarah, Foster Caroline
Department of Medicine, Imperial College London, London, UK.
Imperial College Healthcare NHS Trust, London, UK.
AIDS Care. 2024 Mar;36(3):320-325. doi: 10.1080/09540121.2022.2114986. Epub 2022 Aug 25.
We compared virological and immunological outcomes for young adults with perinatally-acquired HIV infection (YAPaHIV) in the year preceding, and year of, UK SARS-CoV-2 lockdown restrictions, in a service that maintained face-to-face appointments. Retrospective single-centre cohort analysis from; Period 1(P1) twelve months before the first national lockdown - 23rd March 2019-23rd March 2020, period 2(P2) twelve months of varied restrictions - 24th March 2020-24th March 2021. Data collected from electronic records included age, ethnicity, sex, HIV viral load (VL) (suppression ≤ 200 copies/ml), CD4 count (cells/μL), clinical events, and appointment frequency/modality. Descriptive analysis was comparative between periods. Of 177 YAPaHIV: 56% were female, 86.9% were black, median age at lockdown 23 years (IQR: 21-27). One individual was lost to follow up and excluded from subsequent analysis. 147/176 (83.5%) had a suppressed VL in P1 compared with 156/176 (88.6%) in P2. Of those detectable, median VL was 3200 copies/ml (IQR: 925-36500) in P1, and 911copies/ml (IQR: 317-52300) in P2. In P1, median CD4 was 675 (IQR: 447-845.25). 32(18%) had a CD4 < 350 (median 216.5 [IQR: 94.25-269.75]). 110 (59.5%) had a CD4 count in P2, median 551.5cells/μL (IQR: 329.25-761.25). Thirty one had CD4 < 350 (median 202 [IQR: 134.5-296]). Maintaining face-to-face appointments for vulnerable patients, with remote consultation for stable patients, maintained high levels of care engagement and suppression in a YAPaHIV cohort despite pandemic restrictions.
我们在一项保持面对面预约的服务中，比较了在英国实施新冠病毒封锁限制措施的前一年及实施当年，围产期感染艾滋病毒的年轻成年人（YAPaHIV）的病毒学和免疫学结果。进行回顾性单中心队列分析；第1阶段（P1）为首次全国封锁前12个月——2019年3月23日至2020年3月23日，第2阶段（P2）为实施各种限制措施的12个月——2020年3月24日至2021年3月24日。从电子记录中收集的数据包括年龄、种族、性别、艾滋病毒病毒载量（VL）（抑制水平≤200拷贝/毫升）、CD4细胞计数（细胞/微升）、临床事件以及预约频率/方式。各阶段之间进行描述性比较分析。在177例YAPaHIV患者中：56%为女性，86.9%为黑人，封锁时的中位年龄为23岁（四分位间距：21 - 27岁）。1例患者失访，被排除在后续分析之外。在P1阶段，147/176（83.5%）的患者病毒载量得到抑制，而在P2阶段这一比例为156/176（88.6%）。在可检测到病毒载量的患者中，P1阶段的中位病毒载量为3200拷贝/毫升（四分位间距：925 - 36500），P2阶段为911拷贝/毫升（四分位间距：317 - 52300）。在P1阶段，中位CD4细胞计数为675（四分位间距：447 - 845.25）。32例（18%）患者的CD4细胞计数<350（中位值216.5 [四分位间距：94.25 - 269.75]）。在P2阶段，110例（59.5%）患者有CD4细胞计数数据，中位值为551.5细胞/微升（四分位间距：329.25 - 761.25）。31例患者的CD4细胞计数<350（中位值202 [四分位间距：134.5 - 296]）。尽管有疫情限制措施，但为弱势患者保持面对面预约，为病情稳定的患者提供远程咨询，在YAPaHIV队列中维持了较高的护理参与度和病毒抑制水平。
