Changing Characteristics of Patients Living with HIV/AIDS After the COVID-19 Pandemic in Turkey

Hayat Kumbasar Karaosmanoglu; Birgul Mete; Alper Gunduz; Dilek Yildiz Sevgi; Ozlem Altuntas Aydin; Ilyas Dokmetas; Fehmi Tabak

doi:10.2174/1570162X20666220303103805

Changing Characteristics of Patients Living with HIV/AIDS After the COVID-19 Pandemic in Turkey

Curr HIV Res. 2022;20(3):236-241. doi: 10.2174/1570162X20666220303103805.

Authors

Hayat Kumbasar Karaosmanoglu¹, Birgul Mete², Alper Gunduz³, Dilek Yildiz Sevgi³, Ozlem Altuntas Aydin¹, Ilyas Dokmetas³, Fehmi Tabak²

Affiliations

¹ Department of Infectious Diseases and Clinical Microbiology, Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
² Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa University Medical Faculty, Istanbul, Turkey.
³ Department of Infectious Diseases and Clinical Microbiology, Sisli Hamidiye Training and Research Hospital, Istanbul, Turkey.

PMID: 35240974
DOI: 10.2174/1570162X20666220303103805

Abstract

Aims: The COVID-19 pandemic has substantially changed lives and presented several barriers to health services. HIV care continuum needs a high rate of diagnosis, effective treatment, and sustained suppression of viral replication. The COVID-19 pandemic has affected these three steps of HIV care. This study investigated the characteristics of newly diagnosed patients living with HIV/AIDS (PLWH) during the COVID pandemic and compared them with those before the pandemic.

Methods: All newly diagnosed patients in three HIV healthcare centers, in Istanbul, Turkey, were included in the study. The pandemic period included April 1, 2020, to April 1, 2021, and the prepandemic period included March 1, 2019, to March 1, 2020.

Results: 756 patients were diagnosed with HIV/AIDS. In the pandemic period, this figure was 58% less: 315. Patients in the pre-pandemic and pandemic period had comparable age and gender distributions. PLWH diagnosed in the pandemic period had higher rates of low CD4 cells: low CD4 (<350 cells /mm3) was measured in 243 (36.4%) patients in the pre-pandemic period, while it was done in 126 (47.9%) in the pandemic period (p<0.01). Also, the distribution of CD4 cells was significantly different between periods: In the pandemic period, CD4 cell distribution significantly skewed to lower CD4 categories. Symptomatic patient rates and AIDS-defining disorder rates among symptomatic patients were comparable. Viral loads were not significantly different in the two periods.

Conclusion: A low number of newly diagnosed PLWH can be explained by less HIV testing, less admission to health care, or an actual decrease of HIV prevalence during the pandemic. Sexual behaviors may have changed during the COVID-19 pandemic, leading to HIV transmission restriction. Lower CD4 counts among the newly diagnosed PLWH suggest that admittance to health care is late and a significant portion of PLWH remain undiagnosed.

Keywords: AIDS; COVID-19; HIV; antiretroviral therapy; men having sex with men; patients living with HIV/AIDS.

MeSH terms

Acquired Immunodeficiency Syndrome* / epidemiology
COVID-19* / epidemiology
HIV Infections* / diagnosis
HIV Infections* / epidemiology
Humans
Pandemics
Turkey / epidemiology