Evaluation of the impact of the COVID-19 pandemic on treatment response of newly diagnosed people living with HIV: Turkey experience

Abstract

AIM: To evaluate the antiretroviral treatment (ART) in newly diagnosed people living with HIV (PLWH) and to determine treatment response in pre-pandemic and pandemic periods. BACKGROUND: The COVID-19 pandemic has negatively affected the treatment processes of PLWH. METHODS: This multi-centred, retrospective study included newly diagnosed PLWH aged ≥18 years, between pre-pandemic (01.03.2018-29.02.2020) and pandemic (01.03.2020-28.02.2022) period. Demographic data and ART were recorded. RESULTS: Of 2400 PLWH from 23 centres, 88% were male; mean age was 37,5±12,5. At diagnosis, mean CD4 count was 398/mm3, CD4/CD8 ratio 0,47, HIV-RNA 12288990 copies/ml. Among patients, 52% diagnosed during pre-pandemic, 48% during pandemic period. Thirty patients could not be treated because one died before treatment, 29 did not re-apply after diagnosis. Of remaining 2370 patients, 93,4% were started on ≥3 antiretroviral drugs, 6,6% on dual therapy; 97,8% were integrase inhibitor (INSTI), 1,8% protease inhibitor (PI), 0,4% non-nucleoside reverse transcriptase inhibitor (NNRTI) based. Of patients, 64,5% were receiving single-tablet, 35,5% multiple-tablet regimen. The mean CD4 count at 6th month was 602/mm3, CD4/CD8 ratio 0,72. HIV-RNA negativity rates at 1st, 3rd, 6th months were 49%, 76%, 88%, respectively. Comparison of two periods is shown in Table 1. INSTI based combinations (p=0,002) and dual therapy (p=0,000) were used more frequently during the pandemic period. Mean CD4 count, CD4/CD8 ratio at 6th month, and HIV RNA negativity rates were similar in both periods (p>0,05). CONCLUSIONS: INSTI based combinations and two-tablet regimens were used more frequently during the pandemic period. The treatment response was similar in both periods.

Keywords

• HIV
• COVID-19 pandemi
• antiretroviral therapy