EACS2023: 791 Temporal trends in the pattern of antiretroviral therapy prescription before and during COVID-19, Croatia 2017-2022 J. Begovac , V. Romih Pintar , I. Javorić , Š. Zekan School of Medicine University of Zagreb, Zagreb, Croatia, University Hospital for Infectious Diseases, Zagreb, Croatia General data Abstract category: Access and delivery of care Abstract body Purpose: In Croatia, all people living with HIV (PLWH) receive care and collect antiretroviral therapy (ART) at the University Hospital for Infectious Diseases (UHID) in Zagreb. Phone consultations have been part of routine care since 1997, and ART can be delivered to the home address after a phone consultation. We examined the pattern of ART delivery, prescription, and viral suppression in PLWH in 2017-2022. Method: We included PLWH (≥18 years old) who received ART and report different percentages: ART given after a phone consultation, ART given for different time intervals (1 to ≥6 months), annual time spent on different ART combinations, and viral suppression (HIV-1 RNA ≤200 copies/mL). We also report on different times to ART initiation in newly diagnosed PLWH who entered care at UHID. Data were extracted from the electronic database. Results: Of 1605 PLWH, 1576 (98.2%) collected ART. Of 1576, 89.5% were men, 73.4% were MSM, median age was 42.9 years in 2017 and 46.0 years in 2022. There were a total of 23188 consultations for ART prescriptions, >50% of prescriptions were after a phone consultation in 2020 and afterwards (Figure 1A). The number of 3-months ART prescriptions increased in 2020 compared to previous years (Figure 1B). Viral suppression was high among those who had a test done (97%). However, the percentage of PLWH on ART who missed an annual viral load test increased (Figure 1C). Integrase inhibitor-based ART was increasingly prescribed (Figure 1D). The number of newly diagnosed PLWH entering care at UHID decreased (Table), rapid ART was more frequently given (Figure 2), and late presentation was high, but similar to pre-COVID19 years (Table). Table. Main characteristics and initial antiretroviral therapy in 477 newly diagnosed people living with HIV entering HIV care at the University Hospital for Infectious Diseases in Zagreb, Croatia, 2017 to 2022. Total N=477 (%) 2017 to 2019 N=281 (%) 2020 to 2022 N=196 (%) P Value Male gender 451 (94.6) 269 (95.7) 182 (92.9) 0.174 Age, median (Q1-Q3) years 37.8 (29.4 - 46.3) 36.4 (29.0 - 44.7) 38.7 (29.8 - 46.9) 0.056 Transmission 0.889 MSM 415 (87.0) 253 (90.0) 162 (82.7) Hetero 45 (9.3) 20 (7.1) 25 (12.8) Other/Unknown 17 (3.6) 8 (2.9) 9 (4.6) CD4+ cells*, median (Q1-Q3) per μL 290.5 (93.0 - 450.5) 305.5 (104.0 - 452.0) 275.0 (84.0 - 447.0) 0.713 CD4+ cells* < 200 per μL 174 (37.5) 97 (35.9) 77 (39.7) 0.409 HIV-1 RNA **> 100 000 c/ml 230 (50.8) 131 (46.8) 99 (50.8) 0.660 Had clinical AIDS 99 (20.7) 53 (18.9) 46 (23.5) 0.330 Died within 90 days 15 (3.2) 8 (2.9) 7 (3.6) 0.656 Initial antiretroviral therapy*** 0.002 2NRTI+II 380 (80.9) 236 (85.2) 144 (74.6) 1NRTI+II 22 (4.7) 9 (3.3) 13 (6.7) 2NRTI+NNRTI 58 (12.3) 26 (9.4) 32 (16.6) 2NRTI+PI 5 (1.1) 5 (1.8) 0 (0.0) Other 5 (1.1) 1 (0.4) 4 (2.1) Values are frequencies with percentages or median and Q1, Q3. *N=464, **N=475, ***N=470. NRTI; NRTI, nucleoside analogues reverse transcriptase inhibitors; NNRTI, nonnucleoside reverse transcriptase inhibitors; PI, protease inhibitors; II, integrase inhibitors. Conclusions: During COVID-19, the percentage of face-to-face visits with ART prescriptions declined, more 3-months supplies of ART were given, more PLWH missed an annual viral load test, and rapid ART initiation became more common. General conditions 1. I confirm that I previewed this abstract and that all information is correct. I accept that the content of this abstract cannot be modified or corrected after the submission deadline and I am aware that it will be published exactly as submitted.: Yes 2. I confirm that the submission of the abstract constitutes my consent to publication (e.g. conference website, programmes, other promotions, etc.). : Yes 3. I herewith confirm that the contact details saved in this system are those of the corresponding author, who will be notified about the status of the abstract. The corresponding author is responsible for informing the other authors about the status of the abstract.: Yes 4. I agree that all data provided may be used (saved, stored, processed, transmitted and deleted) in compliance with the privacy policy to provide the services described.: Yes 1,2 2 2 1,2 1 2 48 19TH EUROPEAN AIDS CONFERENCE | WARSAW 2023
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