TY - JOUR
T1 - COVID-19 epidemiology and performance of the WHO clinical algorithm to diagnose COVID-19 in people with HIV from Ukraine
AU - Vasylyev, Marta
AU - Buhiichyk, Vira
AU - Buhiichyck, Nadiia
AU - Groenendijk, Albert
AU - Ben, Iryna
AU - Ostapiuk, Lesya
AU - Sluzhynska, Maryana
AU - Bierman, Wouter F.W.
AU - van Kampen, Jeroen J.A.
AU - Wit, Ferdinand W.N.M.
AU - Reiss, Peter
AU - Rijnders, Bart J.A.
AU - Sluzhynska, Oleksandra
AU - Rokx, Casper
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/6
Y1 - 2024/6
N2 - 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.
AB - 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.
KW - AIDS
KW - COVID-19
KW - HIV
KW - Ukraine
KW - WHO COVID-19 case definition
UR - http://www.scopus.com/inward/record.url?scp=85184410219&partnerID=8YFLogxK
U2 - 10.1177/09564624241231016
DO - 10.1177/09564624241231016
M3 - Article
C2 - 38318789
AN - SCOPUS:85184410219
SN - 0956-4624
VL - 35
JO - International Journal of STD and AIDS
JF - International Journal of STD and AIDS
IS - 7
ER -