Impact of the COVID-19 Pandemic on People Newly Diagnosed with HIV and those Already in -care in Türkiye.

Abstract

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.