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在纽约布鲁克林,HIV 感染者在新冠疫情之前和期间的病毒载量抑制情况。

Viral Load Suppression in People Living with HIV Before and During the COVID-19 Pandemic in Brooklyn, New York.

机构信息

Department of Pediatrics, SUNY Downstate Health Sciences University, Box 49, 450 Clarkson Ave, Brooklyn, NY, 11203, USA.

Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, 11203, USA.

出版信息

AIDS Behav. 2024 Sep;28(9):2961-2969. doi: 10.1007/s10461-024-04385-0. Epub 2024 Jun 5.

Abstract

Consistent care is crucial for the health maintenance of people living with human immunodeficiency virus (HIV) (PWH). The coronavirus 2019 (COVID-19) epidemic disrupted patient care in New York City (NYC), yet few studies investigated the association between COVID-19 and viral load suppression in PWH in NYC. This study aims to assess how the COVID-19 pandemic impacted HIV viral load and CD4 + T-cell counts in PWH. Medical records of 1130 adult HIV patients who visited the Special Treatment and Research Health Center in Brooklyn, NY, between January 2019 and May 2023 were compared across three timeframes (pre-pandemic, January 1, 2019 to December 31, 2019; first pandemic phase, March 19, 2020 to December 31, 2020; and second pandemic phase, January 1, 2021 to May 11, 2023). Demographic and clinical variables (e.g. viral load and CD4 + T cell count) were assessed. About 40% of patients did not have routine laboratory monitoring during the first pandemic phase compared with pre-pandemic. The mean HIV viral load was higher during the second pandemic phase compared with pre-pandemic (p = 0.009). The percentages of patients with undetectable HIV viral load and numbers (mm) of CD4 + T-cells were similar for all time periods. These findings indicate that the COVID-19 pandemic may have exacerbated challenges for individuals who already had barriers to medication adherence or access. However, most individuals remained consistently on their antiretrovirals throughout the pandemic. Further studies are warranted to determine how to mitigate the impact of future pandemics for the health of PWH.

摘要

持续的护理对于维护感染人类免疫缺陷病毒 (HIV) 的人的健康至关重要。2019 年冠状病毒病 (COVID-19) 大流行扰乱了纽约市 (NYC) 的患者护理,但很少有研究调查 COVID-19 与 NYC 感染 HIV 者病毒载量抑制之间的关联。本研究旨在评估 COVID-19 大流行如何影响感染 HIV 者的 HIV 病毒载量和 CD4+T 细胞计数。比较了 2019 年 1 月至 2023 年 5 月期间在纽约布鲁克林特殊治疗和研究保健中心就诊的 1130 名成年 HIV 患者的医疗记录,比较了三个时间段(大流行前、2019 年 1 月 1 日至 2019 年 12 月 31 日;大流行第一阶段、2020 年 3 月 19 日至 2020 年 12 月 31 日;和大流行第二阶段、2021 年 1 月 1 日至 2023 年 5 月 11 日)的人口统计学和临床变量(例如病毒载量和 CD4+T 细胞计数)。大约 40%的患者在大流行第一阶段没有进行常规实验室监测,而在大流行前有进行。与大流行前相比,大流行第二阶段的平均 HIV 病毒载量更高(p=0.009)。所有时间段的 HIV 病毒载量不可检测的患者比例和 CD4+T 细胞数量(mm)相似。这些发现表明,COVID-19 大流行可能加剧了那些已经面临药物依从性或获取障碍的人的挑战。然而,大多数人在整个大流行期间仍持续使用抗逆转录病毒药物。需要进一步研究以确定如何减轻未来大流行对感染 HIV 者健康的影响。

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