Brief Report: Impact of the COVID-19 Pandemic on Virological Suppression in People Living With HIV Attending a Large Italian HIV Clinic.

BACKGROUND: We assessed the impact of the coronavirus disease 2019 (COVID-19) pandemic on HIV suppression rates in people living with HIV (PLWH) attending a large Italian HIV clinic. SETTING: The HIV outpatient clinic of the Infectious Diseases Department of Luigi Sacco Hospital, Milan, Italy, which serves more than 5000 PLWH per year. METHODS: A before and after quasi-experimental study design was used to make a retrospective assessment of the monthly trend of HIV-RNA determinations of ≥50 among the PLWH attending our clinic, with "before" being the period from January 1, 2016 to February 20, 2020, and "after" being the period from February 21, 2020 to December 31, 2020 (the COVID-19 period). Interrupted time series analysis was used to evaluate any changes in the trend. RESULTS: During the study period, 70,349 HIV-RNA viral load determinations were made, and the percentage of HIV-RNA viral load determinations of <50 copies/mL increased from 88.4% in 2016 to 93.2% in 2020 (P < 0.0001). There was a significant monthly trend toward a decrease in the number of HIV-RNA determinations of ≥50 copies/mL before the pandemic (ß -0.084; standard error 0.015; P < 0.001), and this did not significantly change after it started (ß -0.039, standard error 0.161; P = 0.811). CONCLUSIONS: A high prevalence of viral suppression was maintained among the PLWH referring to our clinic, despite the structural barriers raised by the COVID-19 pandemic. The use of simplified methods of delivering care (such as teleconsultations and multiple antiretroviral treatment prescriptions) may have contributed to preserving this continuum.

[Dental fluorosis in children in Bár and Dunaszekcsó in the 6-18 age group]. / A fogfluorosis Báron és Dunaszekcsón a 6-18 év közötti korosztályban.

UNLABELLED: Extensive experimental ad clinical data have established that in a concentration of approximately 1 mg/L in drinking water fluoride is highly effective in reducing the incidence of dental caries and dental plaque. However because of its well established cariostatic property, fluoride is being added to dental care and dental health product. In Hungary, community water fluoridation has not occurred, and the fluoride concentration of the drinking water is generally minimal. 95% of the population live in areas of the country where the majority of the population ingests water containing fluoride at a concentration of less than 0.5 mg/L. There are, however, communities in which the natural fluoride concentration in the drinking water is 1.7 or 2.0 mg/L. These are Bár ad Dunaszekcsó. This study is designed to evaluate both prevalence and intensity of dental fluorosis, oral hygiene and periodontal diseases in the children in communities with suboptimal, 1.7x and 2x optimal fluoride concentration of drinking water. MATERIAL AND METHODS: 141 healthy school-children in the 6-18 age groups who were lifetime residents in the communities Bár and Dunaszekcsó, and 140 from Budapest have been asked to participate in this cross-sectional study. The examinations were performed using; the Fluorosis Index of Dean and the Tooth Surface Index of Fluorosis of Horowitz et al. The prevalence and intensity of gingivitis and oral hygiene were determined by the Russell (PI)-index and the Greene Vermillion Oral Hygiene index (OHI-S). RESULTS: 1. The prevalence and intensity of gingivitis and oral hygiene were changing with fluoride concentration in the water supply. 2. On the basis of the number and distribution of the individual scores a community index of dental fluorosis (Fd) were in both community above 0.6, therefore it begins to constitute a public health problem warranting increasing consideration. 3. The intensity of the fluorosis was changed with aging (p < 0.001). This was tested by comparing the fluorosis scores in 6-13 year old children, with the scores for those who were 14-18 years of age. 4. There were no differences in the oral hygiene status and in the intensity of gingivitis between children living in a high-fluoride city and those living in a low-fluoride city. CONCLUSION: The study supports the need of continuous monitoring of the prevalence of dental fluorosis in school-age children. Concerning the reduction in gingivitis and the oral hygiene status the authors found no differences between children living in a high-fluoride or in a low fluoride city.