HIV Patients Lost to Follow-Up During the Covid 19 Pandemic

Abstract

Introduction: The SARS COV 2 pandemic and related lockdown policy have led to an exceptional health crisis, with a potential impact on the care of chronically ill patients, including those living with HIV (PLHIV). Objective: To estimate the incidence of missing patients among PLHIV during the covid 19 pandemic and to identify the contributing factors and their impact on their medical follow-up. Materials and methods: Retrospective descriptive and analytical study of 30 PLHIV who interrupted their follow-up (lost to follow-up) at the ambulatory clinic of the infectious diseases department at the University Hospital Med VI Marrakech from June 2020 to December 2021. Results: The number of patients lost to follow-up was 30. The mean age was 39.25, ranging from 22 to 65 years. A male predominance was noticed, as 65% of the patients were men. Among the patients lost to follow-up: 60% were former patients, while 40% were newly diagnosed. The mean duration of follow-up was 15.35 months, from 6 months to 2 years. HIV stages were Stage A in 50% of cases, Stage B in 15% and Stage C in 35%. The mean CD4 count was 467 cells/mm3. As for viral load, it was only recorded in 60% of patients, with an average of 129605 copies/ml. Regarding treatment, 85% of patients were on triple therapy, while 15% were not yet on treatment. The identified causes for discontinuation were social causes in 40% of cases, psychological causes in 17% of cases, causes linked to the Covid 19 pandemic in 36% of cases, and other causes in 7% of cases. Follow-up was resumed by 54% of patients, while complications were recorded in 35% of cases. Conclusion: Our study demonstrates the deleterious impact of the COVID-19 pandemic on the management of HIV infection and underscores the necessity of developing and implementing new effective strategies to mitigate its negative effects on a vulnerable population, such as people living with HIV (PLHIV).