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Principal Investigator: Hongtao Yu
Organization: MORGAN STATE UNIVERSITY
Fiscal Year: 2022
Award: $271,599
Funding agency: National Institute on Minority Health and Health Disparities
PROJECT SUMMARY
The goal of this HIV/HCV/COVID-19 supplement project is to expand the original study cohort for studying (1)
the feasibility of and barriers to achieving HCV elimination among people living with HIV (PLWH) and people at
risk of HIV (PARH) through linkage to HIV care and prevention and (2) the impact of COVID-19 pandemic and
lockdown on HIV and HCV continuum of care and health outcomes. The original study cohort included HIV-
infected men engaged in HIV primary care at a large, multisite community health center from 2003 to 2014. In
this supplement project, we will expand the study cohort, from 2014 to 2024, and include additional minorities of
PLWH and PARH receiving HIV care or HIV pre-exposure prophylaxis (PrEP), respectively, at the clinics of this
community health center, such as women, transgender women/men, and rural dwellers. In addition, we will
extend the study sites to include a large multi-hospital healthcare system, with which my lab has established a
formal research partnership through the ongoing NIMHD-supported COVID-19 supplement project. The HIV
clinics of the community health center and the healthcare system are situated in urban and suburban Baltimore
and rural Maryland with major health disparities and provide HIV care and preventive services to people of racial,
sexual, and/or gender minorities and other socioeconomically disadvantaged populations. Based on the findings
from the original cohort, we hypothesize that (1) elimination of HCV health disparities and disease burdens could
be achieved for the PLWH and PARH by engaging in HIV care or preventive services, respectively, and (2)
certain circumstances and determinants could pose barriers to achieving this anticipated result. We will perform
a longitudinal retrospective cohort study with data derived from the medical records to assess various aspects
of HCV infection and care among the PLWH and PARH. First, we will determine trends and factors associated
with surveillance testing, prevalence, incidence, treatment initiation and completion, eradication, and re-
occurrence of viremic HCV among the PLWH and PARH. All of these HCV-related outcome measures (referred
as to the “HCV elimination package”) will be analyzed in the context of continuum of HIV care or PrEP usage
and other HIV-related virologic and immunologic parameters. Next, we will assess the HIV continuum of care
during the COVID-19 pandemic, analyzing the trends and factors associated with missing appointments, labs,
and/or prescriptions as well as utilization of telehealth for HIV care and preventive services. We will also examine
the HIV-related health outcomes among the PLWH and PARH prior to, during, and after the pandemic. Similarly,
each of the measures involved in the “HCV elimination package” will be assessed to determine the impact of
COVID-19 lockdown and HIV care/preventive service interruption on HCV elimination endeavours. Finally, we
will use the ongoing study cohort of >5,600 hospitalized COVID-19 patients in this multi-hospital health care
system to delineate the clinical features and determine factors associated with COVID-19 pathogenesis, disease
severity, and treatment outcomes among those with and without HIV and/or HCV coinfections.
PROJECT SUMMARY
Terms: <2019 novel corona virus><2019 novel coronavirus><2019-nCoV><21+ years old><AIDS Virus><Access to Care><Acquired Immune Deficiency Syndrome Virus><Acquired Immunodeficiency Syndrome Virus><Address><Adult><Adult Human><African American group><African American individual><African American people><African American population><African Americans><Antiviral Agents><Antiviral Drugs><Antivirals><Appointment><Baltimore><CD4 Lymphocyte Count><CD4+ Cell Counts><CD4+ Counts><COVID crisis><COVID disease severity><COVID epidemic><COVID infected patient><COVID pandemic><COVID patient><COVID positive patient><COVID severity><COVID-19><COVID-19 affected><COVID-19 consequence><COVID-19 crisis><COVID-19 disease severity><COVID-19 effect><COVID-19 epidemic><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 impact><COVID-19 impacted><COVID-19 infected patient><COVID-19 outbreak><COVID-19 pandemic><COVID-19 pandemic affected><COVID-19 pandemic consequence><COVID-19 pandemic effects><COVID-19 pandemic impact><COVID-19 pandemic impacted><COVID-19 pathogenesis><COVID-19 patient><COVID-19 positive patient><COVID-19 public health crisis><COVID-19 severity><COVID-19 virus><COVID19><COVID19 crisis><COVID19 disease severity><COVID19 epidemic><COVID19 global health crisis><COVID19 global pandemic><COVID19 health crisis><COVID19 outbreak><COVID19 pandemic><COVID19 pathogenesis><COVID19 patient><COVID19 positive patient><COVID19 public health crisis><COVID19 severity><COVID19 virus><CV-19><CV19><Caring><Cessation of life><Characteristics><Chronic Hepatitis C><Chronic type C viral hepatitis><Chronic viral hepatitis C><Clinic><Clinic Visits><Clinical><CoV-2><CoV2><Cohort Studies><Communities><Community Health Centers><Concurrent Studies><Continuity of Care><Continuity of Patient Care><Continuum of Care><Data><Death><Drug user><Epidemic><Evaluation><Frequencies><Gender><Goals><HCV><HCV Acquisition><HCV Incidence><HCV Prevalence><HCV co-infection><HCV coinfection><HCV infection><HCV/HIV><HIV><HIV and HCV><HIV and hepatitis C><HIV diagnosis><HIV-HCV><HIV/HCV><HIV/Hepatitis C><Health><Health Care Systems><Health Disparities Research><Health Services Accessibility><Health disparities related research><Healthcare><Healthcare Systems><Hepatic Disorder><Hepatitis C><Hepatitis C Acquisition><Hepatitis C Incidence><Hepatitis C Prevalence><Hepatitis C co-infection><Hepatitis C virus><Hepatitis C virus infection><Hepatitis, Viral, Non-A, Non-B, Parenterally-Transmitted><Hepatitus C><Hospitals><Human Immunodeficiency Viruses><IFN><Immunochemical Immunologic><Immunologic><Immunological><Immunologically><Immunologics><Incidence><Infection><Interferons><Interruption><LAV-HTLV-III><LGBTI><Lesbian Gay Bi-sexual Transgender Intersex><Lesbian Gay Bisexual Transgender Intersex><Liver><Liver Fibrosis><Liver diseases><Lymphadenopathy-Associated Virus><MSM><Maryland><Measures><Mechanical Ventilators><Medical Records><Minority><Minority 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corona virus 2><SARS-associated coronavirus 2><SARS-coronavirus-2><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><SARS-related corona virus 2><SARS-related coronavirus 2><SARSCoV2><Satellite Centers><Services><Severe Acute Respiratory Coronavirus 2><Severe Acute Respiratory Distress Syndrome CoV 2><Severe Acute Respiratory Distress Syndrome Corona Virus 2><Severe Acute Respiratory Distress Syndrome Coronavirus 2><Severe Acute Respiratory Syndrome CoV 2><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe Acute Respiratory Syndrome-associated coronavirus 2><Severe Acute Respiratory Syndrome-related coronavirus 2><Severe acute respiratory syndrome associated corona virus 2><Severe acute respiratory syndrome corona virus 2><Severe acute respiratory syndrome coronavirus 2><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 outbreak><Severe acute respiratory syndrome coronavirus 2 pandemic><Severe acute respiratory syndrome related corona virus 2><Severities><Severity of illness><Site><Socioeconomically disadvantaged><Study Type><T4 Lymphocyte Count><Temporal trend><Testing><Time><Time trend><Transmission><Treatment outcome><Trends over time><Viral><Viral Burden><Viral Load><Viral Load result><Viremia><Virus><Virus-HIV><Woman><Wuhan coronavirus><access to health services><access to services><access to treatment><accessibility to health services><adolescent man><adolescent men><adulthood><anti-viral agents><anti-viral compound><anti-viral drugs><anti-viral medication><anti-viral therapeutic><anti-virals><antiviral compound><antiviral medication><antiviral therapeutic><availability of services><base><black male><black men><burden of disease><burden of illness><care access><care services><care systems><chronic HCV infection><chronic hepatitis C virus infection><cohort><community clinic><corona virus disease 2019><corona virus disease 2019 epidemic><corona virus disease 2019 pandemic><coronavirus disease 2019><coronavirus disease 2019 consequence><coronavirus disease 2019 crisis><coronavirus disease 2019 disease severity><coronavirus disease 2019 effect><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 impact><coronavirus disease 2019 infected patient><coronavirus disease 2019 outbreak><coronavirus disease 2019 pandemic><coronavirus disease 2019 pandemic consequence><coronavirus disease 2019 pandemic impact><coronavirus disease 2019 pathogenesis><coronavirus disease 2019 patient><coronavirus disease 2019 positive patient><coronavirus disease 2019 public health crisis><coronavirus disease 2019 severity><coronavirus disease 2019 virus><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease infected patient><coronavirus disease pandemic><coronavirus disease 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non B><hepatopathy><high risk sex activity><high risk sex behavior><high risk sexual activity><high risk sexual behavior><injection drug use><innovate><innovation><innovative><liver disorder><men><men who have sex with men><men who have sex with other men><men's><minority health disparity><multidrug use><multiple drug use><nCoV2><non A, non B hepatitis><non-A, non-B hepatitis><older men><pandemic><pandemic disease><parent project><patient infected with COVID><patient infected with COVID-19><patient infected with SARS-CoV-2><patient infected with coronavirus disease><patient infected with coronavirus disease 2019><patient infected with severe acute respiratory syndrome coronavirus 2><patient with COVID><patient with COVID-19><patient with COVID19><patient with SARS-CoV-2><patient with coronavirus disease><patient with coronavirus disease 2019><patient with severe acute respiratory distress syndrome coronavirus 2><people who use drugs><people who use illicit drugs><persons who use drugs><poly drug use><polydrug use><post-COVID><post-COVID-19><post-coronavirus disease 2019><pre-exposure prophylaxis><primary care setting><race disparity><racial disparity><racial inequality><racial inequity><racial minority><racially unequal><risky sexual behavior><rural area><rural dwellers><rural location><rural region><rural resident><service availability><severe acute respiratory syndrome coronavirus 2 disease severity><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><severe acute respiratory syndrome coronavirus 2 infected patient><severe acute respiratory syndrome coronavirus 2 patient><severe acute respiratory syndrome coronavirus 2 positive patient><severe acute respiratory syndrome coronavirus 2 severity><sexual minority><social health determinants><socio-economic disadvantage><socio-economically disadvantaged><socio-economically underprivileged><socioeconomic disadvantage><socioeconomically underprivileged><study design><suburb><suburban><suburbia><syndemic><synergistic epidemic><telehealth><trans-women><transgender women><transmission process><transwoman><transwomen><treatment access><trend><trend analysis><uptake><urban health disparities><viraemia><viral sepsis><virusemia><years of life lost to disability><years of life lost to disease><young man>