Evaluation of virologic suppression rates during the COVID-19 pandemic with outpatient interdisciplinary HIV care.

Abstract

IntroductionThe Coronavirus Disease 2019 (COVID‐19) pandemic has presented social distancing challenges leading healthcare systems to adapt and utilize telemedicine platforms more than ever before. Reducing patient exposure to COVID‐19 became a primary concern, especially for populations at an increased risk for severe illness, such as human immunodeficiency virus (HIV) positive patients.ObjectivesThe primary objective of this study was to measure the impact of pharmacy services including telehealth through the percentage of virologically suppressed patients (HIV ribonucleic acid [RNA] < 200 copies/mL) during the pre‐COVID and post‐COVID time periods. Secondary objectives included the percentage of patients with undetectable viral loads (HIV RNA < 20 copies/mL), percentage of patients with cluster of differentiation 4 (CD4) cell counts greater than 200 cells/mm3, and changes in CD4 cell counts and percentages pre‐COVID and post‐COVID.MethodsThis was a retrospective chart review at a single center HIV primary care clinic in Brooklyn, NY evaluating electronic medical records (EMRs) of 211 HIV‐positive patients. Pre‐COVID was defined as 1 year prior to March 13, 2020, and post‐COVID was defined as March 13 to July 20, 2020.ResultsViral load suppression rates for pre and post‐COVID were 88.6% and 85.3%, respectively (P = .28). Undetectable viral load rates for pre and post‐COVID were approximately 81.5% and 74.4% (P = .096). Mean CD4 cell counts and percentages were 617 cells/mm3 and 29% for pre‐COVID, and 460 cells/mm3 and 22% for post‐COVID. CD4 cell counts greater than 200 cells/mm3 pre‐COVID and post‐COVID was 92.6% and 78.3%, respectively (P = .001).ConclusionUtilization of pharmacy services including telehealth, may allow clinical pharmacists to collaboratively provide remote services without jeopardizing patient outcomes. Larger studies are needed to confirm these findings, and display the long‐term impact and satisfaction of these services.