Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.
Faculty of Public Health, Université Catholique de Louvain, Brussels, Belgium.
BMC Infect Dis. 2022 Dec 3;22(1):901. doi: 10.1186/s12879-022-07879-1.
BACKGROUND: To gain insight into the impact of the COVID-19 pandemic and containment measures on the HIV epidemic and services, this study aims to describe HIV trends in 2020 and compare them with previous years. METHODS: Belgian national HIV surveillance data 2017-2020 were analysed for trends in HIV testing, HIV diagnoses, VL measurements, ART uptake and PrEP purchase. Descriptive statistics from 2020 are compared to annual averages from 2017 to 2019 (proportional difference, %). RESULTS: In 2020, 725 HIV infections were diagnosed in Belgium (- 21.5% compared to 2019). The decline was most pronounced during the first lockdown in April-May but also present in July-December. The number of HIV tests performed decreased by 17.6% in 2020, particularly in March-May and October-December (- 57.5% in April and -25.4% in November 2020 compared to monthly 2017-19 numbers). Diagnosis of acute HIV infections decreased by 47.1% in 2020 (n = 27) compared to 2019 (n = 51). Late HIV diagnoses decreased by 24.7% (95% CI [- 40.7%; -9.7%]) in 2020 compared to 2019. Of patients in care in 2019, 11.8% interrupted HIV care in 2020 compared to 9.1% yearly in the 3 previous years. The number of HIV patients with VL monitoring per month dropped in March-May 2020, whilst proportions of VL suppression and ART coverage remained above 86% and 98.5% respectively in 2020. PrEP purchases, number of purchasers and starters dropped during April-May 2020 (respectively - 45.7%, - 47.4%, - 77.9% in April compared to February 2020). CONCLUSIONS: The significant decrease in HIV diagnoses in Belgium in 2020 coincided with the COVID-19 pandemic and following containment measures, particularly in April-May during the first lockdown. A slowdown of HIV transmission due to reduced HIV risk exposure is suggested by the halving in diagnosis of acute HIV infections in March-December 2020 compared to the previous year, and the adaptive decrease in PrEP use and PrEP initiation from April onwards. Despite a slight increase in HIV care interruptions, the indicators of quality of HIV care remained stable. Access to prevention, testing and care for all people living with HIV and at risk of acquiring HIV is a priority during and after times of pandemic.
背景：为深入了解 COVID-19 大流行及其遏制措施对艾滋病毒流行和服务的影响，本研究旨在描述 2020 年艾滋病毒趋势，并将其与前几年进行比较。
方法：分析了 2017-2020 年比利时国家艾滋病毒监测数据，以了解艾滋病毒检测、艾滋病毒诊断、病毒载量测量、抗逆转录病毒治疗（ART）的采用和 PrEP 购买的趋势。2020 年的描述性统计数据与 2017 年至 2019 年的年度平均值进行了比较（比例差异，%）。
结果：2020 年，比利时诊断出 725 例艾滋病毒感染（与 2019 年相比下降 21.5%）。下降趋势在 4 月至 5 月的第一次封锁期间最为明显，但在 7 月至 12 月期间也存在。2020 年，艾滋病毒检测数量减少了 17.6%，特别是在 3 月至 5 月和 10 月至 12 月（与 2017-19 年每月数字相比，4 月下降 57.5%，11 月下降 25.4%）。2020 年急性艾滋病毒感染的诊断减少了 47.1%（27 例），而 2019 年为 51 例。2020 年，与 2019 年相比，晚期艾滋病毒诊断减少了 24.7%（95%CI[-40.7%；-9.7%]）。2019 年接受治疗的患者中，2020 年有 11.8%中断了艾滋病毒治疗，而前 3 年每年中断治疗的比例为 9.1%。2020 年 3 月至 5 月，接受艾滋病毒治疗的患者每月监测病毒载量的人数减少，而病毒载量抑制和 ART 覆盖率的比例分别保持在 86%和 98.5%以上。2020 年 4 月至 5 月期间，PrEP 购买量、购买者数量和启动者数量均下降（分别为 4 月与 2 月相比下降 45.7%、47.4%和 77.9%）。
结论：比利时 2020 年艾滋病毒诊断的显著下降与 COVID-19 大流行及其随后的遏制措施相吻合，尤其是在 4 月至 5 月的第一次封锁期间。由于艾滋病毒风险暴露减少，艾滋病毒传播速度减缓，这从 2020 年 3 月至 12 月急性艾滋病毒感染的诊断数量与前一年相比减少了一半，以及从 4 月起 PrEP 的使用和 PrEP 启动的适应性减少可以看出。尽管艾滋病毒护理中断略有增加，但艾滋病毒护理质量的指标仍然稳定。在大流行期间和之后，为所有艾滋病毒感染者和有感染艾滋病毒风险的人提供预防、检测和护理服务是当务之急。
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