CROI 2015The outbreak of Ebola has done serious collateral damage to HIV testing and care at an HIV clinic in a remote area of the West African nation of Guinea. Researchers presented these findings at the 2015 Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle.

The Macenta district of Guinea, which has a population of 300,000, is among the most affected by the recent Ebola outbreak, with 745 cases by the end of 2014. This translated to a cumulative incidence rate of 250 cases per 100,000 people, which was 10 times that of the country as a whole. The monthly incidence in Macenta peaked in September 2014 with 79 cases per 100,000 people.

The researchers looked at how the Ebola epidemic affected a 100-bed HIV hospital in Macenta, analyzing differences in hospital data between 2013 and 2014 and drawing comparisons to Ebola surveillance data.

The availability of HIV services remained stable between 2013 and 2014 at the hospital. One laboratory services employee of the hospital died of Ebola in 2014. In 2014, the clinic prescribed antiretrovirals to 780 patients, a 26 percent increase from the 675 patients in 2013. Three of the patients died of Ebola in 2014.

However, when comparing data concerning August to December 2013 with the same period the following year, the researchers found there was a 40 percent drop in the number of primary care outpatient clinic visits, a 43 percent drop in patient spending on service fees and drugs, a 53 percent drop in newly diagnosed cases of tuberculosis, a 46 percent drop in the number of HIV tests given, a 53 percent drop in people newly diagnosed with the virus, and a 47 percent drop in the number of people newly enrolled in HIV care.

On the upside, while there were 276 clinic visits made by people with HIV during the 2013 period, this figure only dropped by 11 percent during the same period in 2014. Out of the 185 people who were newly enrolled in HIV care in the first half of 2014, 18 percent were lost to follow-up after six months. This compares with a 20 percent six-month lost-to-follow-up figure for the 204 people enrolled during the first half of 2013.

To read the conference abstract, click here.

To read the MedPage Today report, click here.