What Impact Has the COVID-19 Pandemic Had on the Profile of HIV/Tuberculosis Co-Infection?

Introduction: The COVID-19 pandemic has had a significant impact on many aspects of public health, including the management of co-infections such as tuberculosis and HIV. Objective: determine the impact of the COVID-19 pandemic on the incidence, time to diagnosis and profile of HIV/Tuberculosis co-infection. Methods: Retrospective descriptive study conducted from January 2017 to May 2023 including all new patients living with HIV (PLHIV) admitted to the Infectious Diseases Department of the Mohammed VI University Hospital of Marrakech during three periods: pre-COVID (2017-2019), per-COVID (2020-2021) and post-COVID (2022-May 2023). Results: In our study, the incidence of HIV infection increased markedly during the post-COVID period compared with the pre-COVID and per-COVID periods: 157.3 cases/year, 123 cases/year and 88.5 cases/year respectively. We also noted́ a delay in the diagnosis of HIV infection during the per-COVID period, explaining the evolution of HIV infection to stage C. In addition, the incidence of tuberculosis increased markedly during the post-COVID period, with a predominance of multifocal and severe forms, explained by the delay in diagnosis due to confinement. Our study thus shows the negative impact of the pandemic on the diagnosis and prognosis of HIV/TB co-infection. Conclusion: HIV/Tuberculosis co-infection was profoundly affected by the COVID-19 pandemic, highlighting the shortcomings of existing healthcare systems and the need to strengthen the resilience of public health programmes to deal with multiple simultaneous crises. The lessons learned from this period can guide future efforts to improve the integrated management of infectious diseases and strengthen the resilience of global health systems.