Infectious Diseases and Clinical Microbiology Department, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkiye.
Infectious Diseases and Clinical Microbiology Department, Izmir Tepecik Education and Research Hospital, Ministry of Health Sciences University, Izmir, Turkiye.
Curr HIV Res. 2024;22(5):290-297. doi: 10.2174/011570162X310343240812055718.
COVID-19 has inevitably influenced health systems. HIV testing rates have been reduced, and access to antiretroviral treatment has been scaled down. We evaluated the impact of COVID-19 on the management of people living with HIV (PLWH) in Türkiye.
We conducted a cross-sectional study in three tertiary care hospitals. We compared the baseline characteristics at the first visit and viral suppression rates at the 24th week of new HIV diagnoses during the pandemic with those during the previous two years. To observe the effect of the pandemic on people living with HIV who were already in care, we compared the metabolic and clinical parameters like weight, blood pressure, blood lipid levels, fasting glucose levels, and liver and renal function tests, of the same people before and during the pandemic.
The first group included 380 cases (127 diagnosed during the pandemic and 253 diagnosed during the previous year). The demographic characteristics were similar. The newly diagnosed PLWH during the pandemic had significantly higher baseline HIV RNA levels (p=0.005), a lower number of clinical visits (p=0.0005), and a lower number of cases with undetectable viral loads at 24 weeks of treatment (p=0.0005) than those diagnosed during the pre-pandemic period. The second group included 261 individuals with a mean follow-up duration of 24.7 (SD± 3.5; min- max 12-144) months. The comparison of laboratory parameters revealed that in the postpandemic period, virologic suppression was maintained at 90.1%, body mass index (p=0,0001), total cholesterol (p=0,0001), and LDL levels (p=0,0001) increased significantly, and creatinine levels decreased significantly (p=0,0001).
Our study showed that COVID-19 deteriorated the HIV management of PLHIV. Strengthening the medical infrastructure of basic services for PLWH is critical for future crises.
COVID-19 不可避免地影响了卫生系统。HIV 检测率下降,抗逆转录病毒治疗的可及性降低。我们评估了 COVID-19 对土耳其 HIV 感染者(PLWH)管理的影响。
我们在三家三级保健医院进行了一项横断面研究。我们比较了大流行期间新诊断的 HIV 感染者首次就诊时的基线特征和第 24 周时的病毒抑制率与前两年的情况。为了观察大流行对已经接受护理的 HIV 感染者的影响,我们比较了同一人群在大流行前后的体重、血压、血脂水平、空腹血糖水平以及肝肾功能检查等代谢和临床参数。
第一组包括 380 例患者(127 例在大流行期间诊断,253 例在大流行前一年诊断)。人口统计学特征相似。大流行期间新诊断的 PLWH 具有更高的基线 HIV RNA 水平(p=0.005)、更少的临床就诊次数(p=0.0005)和更少的在治疗 24 周时病毒载量不可检测的病例(p=0.0005)。第二组包括 261 名患者,平均随访时间为 24.7(SD±3.5;min-max 12-144)个月。实验室参数比较显示,在后疫情时期,90.1%的患者维持了病毒学抑制,体重指数(p=0.0001)、总胆固醇(p=0.0001)和 LDL 水平(p=0.0001)显著升高,而肌酐水平显著降低(p=0.0001)。
我们的研究表明,COVID-19 恶化了 PLHIV 的 HIV 管理。加强基本服务的医疗基础设施对未来的危机至关重要。