Affiliation:
1. Department of Genitourinary Medicine & HIV, St Mary's Hospital Imperial College Healthcare NHS Trust London UK
2. Department of Infectious Disease, Faculty of Medicine Imperial College London London UK
3. Institute for Global Health University College London London UK
4. National Institute for Health and Care Research (NIHR) Health Protection Research Unit (HPRU) in Blood Borne and Sexually Transmitted Infections at UCL UK
Abstract
AbstractObjectivesIn response to the COVID‐19 pandemic, HIV outpatient attendances were restricted from March 2020, resulting in reduced frequency of HIV viral load (VL) monitoring (previously 6‐monthly) in clinically stable and virologically suppressed people living with HIV (PLWH). We investigated virological outcomes during this period of reduced monitoring and compared with the previous year, prior to the COVID‐19 pandemic.MethodsPeople living with HIV with undetectable VL (<200 HIV RNA copies /mL) on antiretroviral therapy (ART) were identified from March 2018 to February 2019. We determined VL outcomes during the pre‐COVD‐19 period (March 2019–February 2020) and the COVID‐19 period (March 2020–February 2021) when monitoring was restricted. Frequency and longest durations between VL tests in each period were evaluated, and virological sequelae in those with detectable VL were determined.ResultsOf 2677 PLWH virologically suppressed on ART (March 2018–February 2019), VLs were measured and undetectable in 2571 (96.0%) and 2003 (77.9%) in the pre‐COVID and COVID periods, respectively. Mean (SD) numbers of VL tests were 2.3 (1.08) and 1.1 (0.83) and mean longest duration between VL tests was 29.5 weeks (SD 8.25, 3.1% were ≥12 months) and 43.7 weeks (12.64, 28.4% were ≥12 months), in the pre‐COVID and COVID periods, respectively. Of 45 individuals with one or more detectable VL during the COVID‐19 period, two developed new drug resistance mutations.ConclusionReduced VL monitoring was not associated with poorer virological outcomes in the majority of stable individuals receiving ART. One in 20 individuals had not returned for VL testing after ≥31 months and the risk of harm in these individuals is unknown.
Subject
Pharmacology (medical),Infectious Diseases,Health Policy
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