Gulzar H Shah, Gina D Etheredge, Stacy W Smallwood, Lievain Maluantesa, Kristie C Waterfield, Osaremhen Ikhile, John Ditekemena, Elodie Engetele, Elizabeth Ayangunna, Astrid Mulenga, Bernard Bossiky
{"title":"刚果民主共和国金沙萨和上加丹加在2019冠状病毒病前后对艾滋病毒载量的抑制","authors":"Gulzar H Shah, Gina D Etheredge, Stacy W Smallwood, Lievain Maluantesa, Kristie C Waterfield, Osaremhen Ikhile, John Ditekemena, Elodie Engetele, Elizabeth Ayangunna, Astrid Mulenga, Bernard Bossiky","doi":"10.4102/sajhivmed.v23i1.1421","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease 2019 (COVID-19) pandemic resulted in unique programmatic opportunities to test hypotheses related to the initiation of antiretroviral treatment (ART) and viral load (VL) suppression during a global health crisis, which would not otherwise have been possible.</p><p><strong>Objectives: </strong>To generate practice-relevant evidence on the impact of initiating ART pre-COVID-19 versus during the COVID-19 pandemic on HIV VL.</p><p><strong>Method: </strong>Logistic regression was performed on data covering 6596 persons with HIV whose VL data were available, out of 36 585 persons who were initiated on ART between 01 April 2019 and 30 March 2021.</p><p><strong>Results: </strong>After controlling for covariates such as age, gender, duration on ART, tuberculosis status at the time of the last visit, and rural vs urban status, the odds of having a VL < 1000 copies/mL were significantly higher for clients who started ART during the COVID-19 pandemic than the year before COVID-19 (adjusted odds ratio [AOR]: 2.50; confidence interval [CI]: 1.55-4.01; <i>P</i> < 0.001). Odds of having a VL < 1000 copies/mL were also significantly higher among female participants than male (AOR: 1.23; CI: 1.02-1.48), among patients attending rural clinics compared to those attending urban clinics (AOR: 1.83; CI: 1.47-2.28), and in clients who were 15 years or older at the time of their last visit (AOR: 1.50; CI: 1.07-2.11).</p><p><strong>Conclusion: </strong>Viral loads did not deteriorate despite pandemic-induced changes in HIV services such as the expansion of multi-month dispensing (MMD), which may have played a protective role regardless of the general negative impacts of response to the COVID-19 crises on communities and individuals.</p><p><strong>What this study adds: </strong>This research capitalises on the natural experiment of COVID-19-related changes in HIV services and provides new practice-relevant research evidence.</p>","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2022-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9634654/pdf/","citationCount":"2","resultStr":"{\"title\":\"HIV viral load suppression before and after COVID-19 in Kinshasa and Haut Katanga, Democratic Republic of the Congo.\",\"authors\":\"Gulzar H Shah, Gina D Etheredge, Stacy W Smallwood, Lievain Maluantesa, Kristie C Waterfield, Osaremhen Ikhile, John Ditekemena, Elodie Engetele, Elizabeth Ayangunna, Astrid Mulenga, Bernard Bossiky\",\"doi\":\"10.4102/sajhivmed.v23i1.1421\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The coronavirus disease 2019 (COVID-19) pandemic resulted in unique programmatic opportunities to test hypotheses related to the initiation of antiretroviral treatment (ART) and viral load (VL) suppression during a global health crisis, which would not otherwise have been possible.</p><p><strong>Objectives: </strong>To generate practice-relevant evidence on the impact of initiating ART pre-COVID-19 versus during the COVID-19 pandemic on HIV VL.</p><p><strong>Method: </strong>Logistic regression was performed on data covering 6596 persons with HIV whose VL data were available, out of 36 585 persons who were initiated on ART between 01 April 2019 and 30 March 2021.</p><p><strong>Results: </strong>After controlling for covariates such as age, gender, duration on ART, tuberculosis status at the time of the last visit, and rural vs urban status, the odds of having a VL < 1000 copies/mL were significantly higher for clients who started ART during the COVID-19 pandemic than the year before COVID-19 (adjusted odds ratio [AOR]: 2.50; confidence interval [CI]: 1.55-4.01; <i>P</i> < 0.001). Odds of having a VL < 1000 copies/mL were also significantly higher among female participants than male (AOR: 1.23; CI: 1.02-1.48), among patients attending rural clinics compared to those attending urban clinics (AOR: 1.83; CI: 1.47-2.28), and in clients who were 15 years or older at the time of their last visit (AOR: 1.50; CI: 1.07-2.11).</p><p><strong>Conclusion: </strong>Viral loads did not deteriorate despite pandemic-induced changes in HIV services such as the expansion of multi-month dispensing (MMD), which may have played a protective role regardless of the general negative impacts of response to the COVID-19 crises on communities and individuals.</p><p><strong>What this study adds: </strong>This research capitalises on the natural experiment of COVID-19-related changes in HIV services and provides new practice-relevant research evidence.</p>\",\"PeriodicalId\":49489,\"journal\":{\"name\":\"Southern African Journal of Hiv Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2022-10-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9634654/pdf/\",\"citationCount\":\"2\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Southern African Journal of Hiv Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4102/sajhivmed.v23i1.1421\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Southern African Journal of Hiv Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4102/sajhivmed.v23i1.1421","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
HIV viral load suppression before and after COVID-19 in Kinshasa and Haut Katanga, Democratic Republic of the Congo.
Background: The coronavirus disease 2019 (COVID-19) pandemic resulted in unique programmatic opportunities to test hypotheses related to the initiation of antiretroviral treatment (ART) and viral load (VL) suppression during a global health crisis, which would not otherwise have been possible.
Objectives: To generate practice-relevant evidence on the impact of initiating ART pre-COVID-19 versus during the COVID-19 pandemic on HIV VL.
Method: Logistic regression was performed on data covering 6596 persons with HIV whose VL data were available, out of 36 585 persons who were initiated on ART between 01 April 2019 and 30 March 2021.
Results: After controlling for covariates such as age, gender, duration on ART, tuberculosis status at the time of the last visit, and rural vs urban status, the odds of having a VL < 1000 copies/mL were significantly higher for clients who started ART during the COVID-19 pandemic than the year before COVID-19 (adjusted odds ratio [AOR]: 2.50; confidence interval [CI]: 1.55-4.01; P < 0.001). Odds of having a VL < 1000 copies/mL were also significantly higher among female participants than male (AOR: 1.23; CI: 1.02-1.48), among patients attending rural clinics compared to those attending urban clinics (AOR: 1.83; CI: 1.47-2.28), and in clients who were 15 years or older at the time of their last visit (AOR: 1.50; CI: 1.07-2.11).
Conclusion: Viral loads did not deteriorate despite pandemic-induced changes in HIV services such as the expansion of multi-month dispensing (MMD), which may have played a protective role regardless of the general negative impacts of response to the COVID-19 crises on communities and individuals.
What this study adds: This research capitalises on the natural experiment of COVID-19-related changes in HIV services and provides new practice-relevant research evidence.
期刊介绍:
The Southern African Journal of HIV Medicine is focused on HIV/AIDS treatment, prevention and related topics relevant to clinical and public health practice. The purpose of the journal is to disseminate original research results and to support high-level learning related to HIV Medicine. It publishes original research articles, editorials, case reports/case series, reviews of state-of-the-art clinical practice, and correspondence.