ABSTRACT
BACKGROUND: The COVID-19 pandemic determines the functioning of the healthcare system. The epidemic of HIV infection depends heavily on the effectiveness of the health system and its ability to test and deliver prevention and treatment.This study aims to determine the consequences of this pandemic on the development of HIV infection testing in the Czech Republic. METHODS: A descriptive cross-sectional study analyzed data for two infectious diseases, HIV (2020 and 2015-2019) and COVID-19 (2020), in the Czech Republic. For the statistical comparison of 2020 with the earlier period, the incidence rate ratio (IRR) and Poisson regression methods were used. Monthly HIV and COVID-19 indicators for 2020 were analyzed using correlation analysis. RESULTS AND DISCUSSION: A significant difference was observed only in April (IRR = 0.81; p = 0.046) and July (IRR = 1.27; p = 0.023) between the number of HIV tests performed in each month in 2020 and the control period (average for the same months of the period 2015-2019).Significant differences between the observed periods were further identified for testing reasons. Correlation analysis of the number of tests performed on HIV and COVID-19 after 2020 showed a negative relationship (r = -0.261, p = 0.412). CONCLUSION: The study did not confirm statistically significant differences between the number of HIV tests performed in the pandemic year 2020 compared to the previous period, except for two months. The incidence and number of newly diagnosed cases did not differ statistically significantly from previous years (2015-2019).
ABSTRACT
Background There is currently no evidence suggesting that COVID-19 takes a different course in HIV-positive patients on antiretroviral treatment compared to the general population. However, little is known about the relation between specific HIV-related factors and the severity of the COVID-19 disease. Methods We performed a retrospective analysis of cases collected through an on-line survey distributed by the Euroguidelines in Central and Eastern Europe Network Group. In statistical analyses characteristics of HIV-positive patients asymptomatic/moderate and moderate/severe course were compared. Results In total 34 HIV-positive patients diagnosed with COVID-19 were reported by 12 countries (Estonia, Czech Republic, Lithuania, Albania, Belarus, Romania, Serbia, Bosnia and Herzegovina, Poland, Russia, Hungary, Bulgaria). Asymptomatic courses of COVID-19 were reported in four (12%) cases, 11 (32%) patients presented with mild disease not requiring hospitalization, moderate disease with respiratory and/or systemic symptoms was observed in 14 (41%) cases, and severe disease with respiratory failure was found in five (15%) patients. The only HIV-related characteristics differentiating a moderate/severe course of the disease from asymptomatic/mild disease course was the use of or PI or NNRTI as part of the cART regimen (40.0% vs. 5.3%, p=0.0129 for PI and 31.6 % vs. 0.0%, p= 0.0239 for NNRTI ). Conclusions In our analyses HIV viral suppression and immunological status were not playing a role in the course of COVID-19 disease. On the contrary the cART regimen could contribute to severity of SARS-CoV-2 infection. Large and prospective studies are necessary to further investigate this relations.