BACKGROUND: During the COVID-19 pandemic, patients experienced significant care disruptions, including laboratory monitoring. We investigated changes in the time between viral load (VL) checks for people with HIV (PWH) associated with the pandemic. SETTING AND METHODS: This was an observational analysis of VLs of PWH in routine care at a large subspecialty clinic. At pandemic onset, the clinic temporarily closed its onsite laboratory. The exposure was time period (time varying): prepandemic (January 1, 2019-March 15, 2020); pandemic laboratory closed (March 16-July 12, 2020); and pandemic laboratory open (July 13-December 31, 2020). We estimated time from an index VL to a subsequent VL, stratified by whether the index VL was suppressed (≤200 copies/mL). We also calculated cumulative incidence of a nonsuppressed VL following a suppressed index VL, and of resuppression following a loss of viral suppression. RESULTS: Compared with prepandemic, hazard ratios for next VL check were 0.34 (95% CI: 0.30 to 0.37, laboratory-closed) and 0.73 (CI: 0.68 to 0.78, laboratory-open) for suppressed patients, and 0.56 (CI: 0.42 to 0.79, laboratory-closed) and 0.92 (95% CI: 0.76 to 1.10, laboratory-open) for nonsuppressed patients. The 12-month cumulative incidence of loss of suppression was the same in the pandemic laboratory-open (4%) and prepandemic (4%) period. The hazard of resuppression following the loss of suppression was lower during the pandemic laboratory-open versus the prepandemic period (hazard ratio: 0.68, 95% CI: 0.50 to 0.92). CONCLUSIONS: Early pandemic restrictions and laboratory closure significantly delayed VL monitoring. Once the laboratory reopened, nonsuppressed patients resumed normal monitoring. Suppressed patients still had a delay but no significant loss of suppression.
BACKGROUND: During the COVID-19 pandemic, patients experienced significant care disruptions, including laboratory monitoring. We investigated changes in the time between viral load (VL) checks for people with HIV (PWH) associated with the pandemic. SETTING AND METHODS: This was an observational analysis of VLs of PWH in routine care at a large subspecialty clinic. At pandemic onset, the clinic temporarily closed its onsite laboratory. The exposure was time period (time varying): prepandemic (January 1, 2019-March 15, 2020); pandemic laboratory closed (March 16-July 12, 2020); and pandemic laboratory open (July 13-December 31, 2020). We estimated time from an index VL to a subsequent VL, stratified by whether the index VL was suppressed (≤200 copies/mL). We also calculated cumulative incidence of a nonsuppressed VL following a suppressed index VL, and of resuppression following a loss of viral suppression. RESULTS: Compared with prepandemic, hazard ratios for next VL check were 0.34 (95% CI: 0.30 to 0.37, laboratory-closed) and 0.73 (CI: 0.68 to 0.78, laboratory-open) for suppressed patients, and 0.56 (CI: 0.42 to 0.79, laboratory-closed) and 0.92 (95% CI: 0.76 to 1.10, laboratory-open) for nonsuppressed patients. The 12-month cumulative incidence of loss of suppression was the same in the pandemic laboratory-open (4%) and prepandemic (4%) period. The hazard of resuppression following the loss of suppression was lower during the pandemic laboratory-open versus the prepandemic period (hazard ratio: 0.68, 95% CI: 0.50 to 0.92). CONCLUSIONS: Early pandemic restrictions and laboratory closure significantly delayed VL monitoring. Once the laboratory reopened, nonsuppressed patients resumed normal monitoring. Suppressed patients still had a delay but no significant loss of suppression.
Authors: Peter Rebeiro; Keri N Althoff; Kate Buchacz; John Gill; Michael Horberg; Hartmut Krentz; Richard Moore; Timothy R Sterling; John T Brooks; Kelly A Gebo; Robert Hogg; Marina Klein; Jeffrey Martin; Michael Mugavero; Sean Rourke; Michael J Silverberg; Jennifer Thorne; Stephen J Gange Journal: J Acquir Immune Defic Syndr Date: 2013-03-01 Impact factor: 3.731
Authors: Myron S Cohen; Ying Q Chen; Marybeth McCauley; Theresa Gamble; Mina C Hosseinipour; Nagalingeswaran Kumarasamy; James G Hakim; Johnstone Kumwenda; Beatriz Grinsztejn; Jose H S Pilotto; Sheela V Godbole; Suwat Chariyalertsak; Breno R Santos; Kenneth H Mayer; Irving F Hoffman; Susan H Eshleman; Estelle Piwowar-Manning; Leslie Cottle; Xinyi C Zhang; Joseph Makhema; Lisa A Mills; Ravindre Panchia; Sharlaa Faesen; Joseph Eron; Joel Gallant; Diane Havlir; Susan Swindells; Vanessa Elharrar; David Burns; Taha E Taha; Karin Nielsen-Saines; David D Celentano; Max Essex; Sarah E Hudelson; Andrew D Redd; Thomas R Fleming Journal: N Engl J Med Date: 2016-07-18 Impact factor: 91.245
Authors: Brian R Wood; Jeremy D Young; Rima C Abdel-Massih; Lewis McCurdy; Todd J Vento; Shireesha Dhanireddy; Kay J Moyer; Javeed Siddiqui; John D Scott Journal: Clin Infect Dis Date: 2021-03-15 Impact factor: 9.079
Authors: Jonathan M Tsai; Nicole V Tolan; Athena K Petrides; Sanjat Kanjilal; Manfred Brigl; Neal I Lindeman; Yen-Der Li; Milenko J Tanasijevic; Sankha S Basu; Stacy E F Melanson Journal: J Appl Lab Med Date: 2021-04-06