Journal of Korean medical science
Impact of the COVID-19 Pandemic on Treatment Outcomes and Healthcare Utilization Among People Living With HIV in Korea: A Multicenter Cohort Study
By Nam E, Choi JY, Kim JH and 10 others.
Abstract
Background
The coronavirus disease 2019 (COVID-19) pandemic disrupted healthcare delivery worldwide, raising concerns about continuity of care for people living with HIV (PLWH). However, its long-term effect on HIV treatment outcomes in resource-rich settings with robust public health infrastructure remains unclear. Therefore, this study aims to evaluate the effects of the COVID-19 pandemic on virological outcomes, immunological status, healthcare utilization, medication adherence, and mortality among PLWH enrolled in the Korea HIV/AIDS Cohort.
Methods
A retrospective longitudinal analysis was conducted using the Korea HIV/AIDS Cohort data collected between 2018 and 2023. Outcomes during the pre-pandemic (2018-2019) and pandemic (2020-2023) periods were compared. The primary outcome was virological failure, defined as an HIV RNA level ≥ 200 copies/mL. Secondary outcomes included CD4+ T-cell count, opportunistic infections, visit adherence (≥ 2 clinic visits/year), all-cause mortality, and visual analog scale-assessed self-reported medication adherence. Repeated-measures analyses were performed using generalized estimating equations with an exchangeable correlation structure, adjusted for age and sex. Mortality risk was evaluated using Cox proportional hazards models, with subgroup and sensitivity analyses also performed.