COVID-19 epidemiology and performance of the WHO clinical algorithm to diagnose COVID-19 in people with HIV from Ukraine.

Autor:	Vasylyev M; Department of Internal Medicine, Section Infectious Diseases, and Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands.; Astar Medical Center, Lviv, Ukraine., Buhiichyk V; Astar Medical Center, Lviv, Ukraine., Buhiichyck N; Astar Medical Center, Lviv, Ukraine., Groenendijk A; Department of Internal Medicine, Section Infectious Diseases, and Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands., Ben I; Department of Infectious Diseases, Danylo Halytsky National Medical University, Lviv, Ukraine., Ostapiuk L; Pulmonary Health Center, HIV Unit, Lviv, Ukraine., Sluzhynska M; Lviv Regional Public Health Center, Lviv, Ukraine., Bierman WFW; University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., van Kampen JJA; Department of Viroscience, Erasmus University Medical Center, Rotterdam, The Netherlands., Wit FWNM; Stichting HIV Monitoring, Amsterdam, The Netherlands.; Amsterdam UMC, Location University of Amsterdam, Global Health, Meibergdreef 9, Amsterdam, The Netherlands., Reiss P; Amsterdam UMC, Location University of Amsterdam, Global Health, Meibergdreef 9, Amsterdam, The Netherlands.; Amsterdam Institute for Global Health and Development, Paasheuvelweg 25, Amsterdam, The Netherlands., Rijnders BJA; Department of Internal Medicine, Section Infectious Diseases, and Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands., Sluzhynska O; Astar Medical Center, Lviv, Ukraine., Rokx C; Department of Internal Medicine, Section Infectious Diseases, and Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands.
Jazyk:	angličtina
Zdroj:	International journal of STD & AIDS [Int J STD AIDS] 2024 Jun; Vol. 35 (7), pp. 510-515. Date of Electronic Publication: 2024 Feb 06.
DOI:	10.1177/09564624241231016
Abstrakt:	Background: The two main objectives were to evaluate the COVID-19 point prevalence and the test performance of the WHO case definition to diagnose COVID-19 clinically in people with HIV in West Ukraine. Methods: Multicenter cross-sectional study in Lviv, Ukraine, from October 2020-November 2021. COVID-19 unvaccinated people with HIV were included regardless of COVID-19 symptoms at routine clinical visits and had standardized medical, quality of life (EQ(5D)) and SARS-CoV-2 serology assessments. Reported symptoms indicating potential COVID-19 events at inclusion or between March 2020 and inclusion were classified by the WHO case definition as suspected, probable or confirmed. A clinical COVID-19 case was defined as being SARS-CoV-2 seropositive with at least a suspected COVID-19 according to the WHO case definition. The primary endpoints were the clinical COVID-19 prevalence and the test characteristics of the WHO case definition with SARS-CoV-2 serology as reference. (Clinicaltrials.gov:NCT04711954). Results: The 971 included people with HIV were median 40 years, 38.8% women, 44.8% had prior AIDS, and 55.6% had comorbidities. SARS-CoV-2 seroprevalence was 40.1% (95%CI:37.0-43.1) and 20.5% (95%CI:18.0-23.1) had clinical COVID-19 median 4 months (IQR:2-7) before inclusion. Clinical COVID-19 occurred less frequently in people with HIV with tuberculosis history, injecting drug use, CD4+ T-cells <200/mL and unemployment. The quality of life was not impacted after COVID-19. An at least probable COVID-19 classification by the WHO case definition had 44.1% sensitivity (95%CI:38.7-49.7), 85.2% specificity (95%CI:81.5-88.4), 66.6% positive predictive value (95%CI:59.8-73.0) and 69.5% negative predictive value (95%CI:65.5-73.3) to diagnose COVID-19. Conclusions: COVID-19 unvaccinated people with HIV from Ukraine had a significant COVID-19 rate and using the WHO case definition had insufficient diagnostic accuracy to diagnose these cases. The lower burden in vulnerable people with HIV was unexpected but might reflect a shielding effect. Competing Interests: Declaration of conflicting interestThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Unrestricted grant from ISS program by ViiV Healthcare (grant nr. 214,684) and the Erasmus MC Foundation aware.hiv Ukraine program (https://www.awarehiv.com/ukraine). The funder had no role in the design of the study, data collection, analysis, writing or the decision to submit for publication. The authors declare no other conflict of interest related to this submission. Results from a planned interim analysis at 500 participants have been presented at EACS conference London, 2021.
Databáze:	MEDLINE
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