Outpatient follow-up of people living with HIV-1/Aids in the state of Piauí in the context of the Covid-19 pandemic

Justification and Objectives: The Covid-19 pandemic has posed significant challenges to public health, especially for vulnerable groups such as people living with HIV-1/Aids (PLWHA). This study aimed to analyze the impact of the pandemic on sociodemographic aspects, clinical outcomes and opportunistic infections of PLWHA in outpatient care in Piauí. Methods: An observational epidemiologic study was conducted using retrospective data from medical records of PLWHA receiving outpatient care at the Natan Portella Institute of Tropical Diseases (IDTNP) in Teresina, Piauí. The sample consisted of 334 medical records of patients receiving antiretroviral therapy for at least six months. Results: Antiretroviral therapy (ART) showed significant efficacy before the pandemic, with a decrease in viral load between follow-up visits. During the pandemic, patients showed a decrease in viral load between follow-up visits, but the lack of complete data prevented a comprehensive analysis. CD4+ T-cell counts increased both before and during the pandemic, reflecting ART adherence. There was no significant difference in CD8+ T cell counts. The CD4+/CD8+ T cell ratio showed significant differences, indicating immunologic improvement. The most common opportunistic infections were syphilis, tuberculosis and neurotoxoplasmosis. Conclusion: The Covid-19 pandemic had a negative impact on ART adherence and increased the prevalence of co-infections among PLWHA in Piauí. Adaptive strategies, such as multi-month ART dispensing and the use of telemedicine, were crucial to ensure treatment continuity. This study highlights the need for adaptive public policies to ensure continuity of patient care during public health crises.