In the era of COVID-19, providers are delaying laboratory testing in people with HIV (PWH). The purpose of this study was to examine the clinical significance of renal, liver, and lipid testing. We reviewed the charts of 261 PWH who initiated care at an academic HIV clinic between January 1, 2016 and December 21, 2018. Analysis included one-sided binomial exact tests and multiple linear, Poisson, and Beta regression models. The most common abnormality was a glomerular filtration rate (GFR) <60 mL/min (10%). Age <40 years [estimated relative rate (rr) 0.017, 95% confidence interval (CI) 0.207 to 0.494], cobicistat (rr 0.284, 95% CI 0.128 to 0.63), and tenofovir alafenamide (rr 0.295 95% CI 0.151 to 0.573) were associated with a decreased risk of GFR <60 mL/min. An increased AST and ALT ≥2 × upper limit of normal (ULN) was found in 5% and 3%, respectively. Hepatitis C and use of darunavir and lopinavir were associated with increased AST or ALT. When a GFR was <60 mL/min or an AST or ALT was ≥2 × ULN, no action was taken in 53% of cases. In 18% of cases the only intervention was repeat testing. The most common interventions after lipid results were calculation of a 10-year cardiovascular risk score (31%) and addition of a statin (18%). Taking action after lipid results was strongly associated with age ≥40 (rr 7.37, 95% CI 3.0 to 18.3). Young PWH without hepatitis C rarely have renal, liver, or lipid test results that alter clinical care. Decreased testing should be considered.

中文翻译：

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抗逆转录病毒实验室监测及其对COVID-19时代及以后的HIV临床护理的意义

在COVID-19时代，提供者正在推迟对HIV感染者（PWH）的实验室测试。这项研究的目的是检查肾脏，肝脏和脂质测试的临床意义。我们回顾了2016年1月1日至2018年12月21日在一家学术HIV诊所开始护理的261名PWH的图表。分析包括单侧二项式精确检验和多元线性，泊松和Beta回归模型。最常见的异常是肾小球滤过率（GFR）<60 mL / min（10％）。年龄<40岁[估计相对比率（rr）0.017，95％置信区间（CI）0.207至0.494]，cobicistat（rr 0.284、95％CI 0.128至0.63）和替诺福韦阿拉芬酰胺（rr 0.295 95％CI 0.151至0.573 ）与GFR <60 mL / min降低的风险有关。AST和ALT≥2×正常上限（ULN）升高的比例分别为5％和3％。丙型肝炎以及达那那韦和洛匹那韦的使用与AST或ALT升高有关。当GFR <60 mL / min或AST或ALT≥2×ULN时，在53％的病例中未采取任何措施。在18％的情况下，唯一的干预措施是重复测试。血脂检查结果后最常见的干预措施是计算10年心血管风险评分（31％）和添加他汀类药物（18％）。脂质结果后采取行动与年龄≥40岁密切相关（rr 7.37，95％CI 3.0至18.3）。没有丙型肝炎的年轻PWH很少有会改变临床护理的肾脏，肝脏或脂质测试结果。应考虑减少测试。60 mL / min或AST或ALT≥2×ULN，在53％的病例中未采取任何措施。在18％的情况下，唯一的干预措施是重复测试。血脂检查结果后最常见的干预措施是计算10年心血管风险评分（31％）和添加他汀类药物（18％）。脂质结果后采取行动与年龄≥40岁密切相关（rr 7.37，95％CI 3.0至18.3）。没有丙型肝炎的年轻PWH很少有会改变临床护理的肾脏，肝脏或脂质测试结果。应考虑减少测试。60 mL / min或AST或ALT≥2×ULN，在53％的病例中未采取任何措施。在18％的情况下，唯一的干预措施是重复测试。血脂检查结果后最常见的干预措施是计算10年心血管风险评分（31％）和添加他汀类药物（18％）。脂质结果后采取行动与年龄≥40岁密切相关（rr 7.37，95％CI 3.0至18.3）。没有丙型肝炎的年轻PWH很少有会改变临床护理的肾脏，肝脏或脂质测试结果。应考虑减少测试。脂质结果后采取行动与年龄≥40岁密切相关（rr 7.37，95％CI 3.0至18.3）。没有丙型肝炎的年轻PWH很少有会改变临床护理的肾脏，肝脏或脂质测试结果。应考虑减少测试。脂质结果后采取行动与年龄≥40岁密切相关（rr 7.37，95％CI 3.0至18.3）。没有丙型肝炎的年轻PWH很少有会改变临床护理的肾脏，肝脏或脂质测试结果。应考虑减少测试。