Deniz Gokengin1, Cristiana Oprea2, Josip Begovac3, Andrzej Horban4, Arzu Nazlı Zeka5, Dalibor Sedlacek6, Bayjanov Allabergan7, Esmira A Almamedova8, Tatevik Balayan9, Denes Banhegyi10, Pavlina Bukovinova11, Nikoloz Chkhartishvili12, Alymbaeva Damira13, Edona Deva14, Ivaylo Elenkov15, Luljeta Gashi16, Dafina Gexha-Bunjaku16, Vesna Hadciosmanovic17, Arjan Harxhi18, Tiberiu Holban19, Djorje Jevtovic20, David Jilich21, Justyna Kowalska4, Djhamal Kuvatova13, Natalya Ladnaia22, Adkhamjon Mamatkulov7, Aleksandra Marjanovic23, Maria Nikolova24, Mario Poljak25, Kristi Rüütel26, Azzaden Shunnar11, Milena Stevanovic27, Zhanna Trumova28, Oleg Yurin22. 1. Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University Izmir, Turkey. Electronic address: deniz.gokengin@ege.edu.tr. 2. 'Victor Babes' Clinical Hospital for Infectious and Tropical Diseases, 'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania. 3. University of Zagreb School of Medicine, University Hospital for Infectious Diseases, Zagreb, Croatia. 4. Hospital for Infectious Diseases in Warsaw, Medical University of Warsaw, Warsaw, Poland. 5. Yunus Emre State Hospital, Eskişehir, Turkey. 6. Department of Infectious and Travellers Diseases, Charles University Medical Faculty, Pilsen, Czech Republic. 7. Institute of Virology, Ministry of Public Health of Uzbekistan, Tashkent, Uzbekistan. 8. AIDS Control Centre, Baku, Azerbaijan. 9. National Centre for Disease Control and Prevention of Armenia, Yerevan, Armenia. 10. Szent Laszlo Hospital, Budapest, Hungary. 11. Centre for HIV/AIDS, Clinic of Infectious Diseases, University Hospital, Bratislava, Slovakia. 12. Infectious Diseases, AIDS and Clinical Immunology Research Centre, Tbilisi, Georgia. 13. Department of Infectious Diseases, Division of Medicine, Kyrgyz-Russian Slavonic University, Bishkek, Kyrgyzstan. 14. Community Development Fund, Prishtina, Kosovo. 15. Specialized Hospital for Active Treatment of Infectious and Parasitic Diseases, Sofia, Bulgaria. 16. National Institute of Public Health of Kosovo, Prishtina, Kosovo. 17. Clinical Centre, Infectious Diseases Clinic, University of Sarajevo, Sarajevo, Bosnia and Herzegovina. 18. Infectious Disease Department, Faculty of Medicine, University Hospital Centre of Tirana, Tiran, Albania. 19. State Medical and Pharmaceutical University Nicolae Testemitanu, Department of Infectious Diseases and Medical Parasitology, Chisinau, Republic of Moldova. 20. University of Belgrade School of Medicine, Infectious and Tropical Diseases Hospital, Clinical Centre Serbia, HIV/AIDS Unit, Belgrade, Serbia. 21. Department of Infectious and Tropical Diseases, First Faculty of Medicine, Charles University and Na Bulovce Hospital, Prague, Czech Republic. 22. Central Scientific Research Institute of Epidemiology of Rospotrebnadzor, Russian Federal AIDS Centre, Moscow, Russian Federation. 23. Institute of Public Health, Podgorica, Montenegro. 24. National Reference Laboratory of Immunology, National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria. 25. Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia. 26. National Institute for Health Development, Tallinn, Estonia. 27. Clinic for Infectious Diseases and Febrile Conditions, Skopje, Former Yugoslav Republic of Macedonia. 28. Department of HIV Infection and Infection Control, Kazakh National Medical University, Almaty, Kazakhstan.
Abstract
OBJECTIVES: The aim of this survey was to describe the current status of HIV care in the countries of Central and Eastern Europe and to investigate how close the region is to achieving the UNAIDS 2020 target of 90-90-90. METHODS: In 2014, data were collected from 24 Central and Eastern European countries using a 38-item questionnaire. RESULTS: All countries reported mandatory screening of blood and organ donors for HIV. Other groups subjected to targeted screening included people who inject drugs (PWID) (15/24, 62.5%), men who have sex with men (MSM) (14/24, 58.3%), and sex workers (12/24, 50.0%). Only 14 of the 24 countries (58.3%) screened pregnant women. The percentages of late presentation and advanced disease were 40.3% (range 14-80%) and 25.4% (range 9-50%), respectively. There was no difference between countries categorized by income or by region in terms of the percentages of persons presenting late or with advanced disease. The availability of newer antiretroviral drugs (rilpivirine, etravirine, darunavir, maraviroc, raltegravir, dolutegravir) tended to be significantly better with a higher country income status. Ten countries reported initiating antiretroviral therapy (ART) regardless of CD4+ T cell count (41.7%), five countries (20.8%) used the threshold of <500 cells/μl, and nine countries (37.5%) used the threshold of <350cells/μl. Initiation of ART regardless of the CD4+ T cell count was significantly more common among high-income countries than among upper-middle-income and lower-middle-income countries (100% vs. 27.3% and 0%, respectively; p=0.001). Drugs were provided free of charge in all countries and mostly provided by governments. There were significant discrepancies between countries regarding the follow-up of people living with HIV. CONCLUSIONS: There are major disparities in the provision of HIV care among sub-regions in Europe, which should be addressed. More attention in terms of funding, knowledge and experience sharing, and capacity building is required for the resource-limited settings of Central and Eastern Europe. The exact needs should be defined and services scaled up in order to achieve a standard level of care and provide an adequate and sustainable response to the HIV epidemic in this region.
OBJECTIVES: The aim of this survey was to describe the current status of HIV care in the countries of Central and Eastern Europe and to investigate how close the region is to achieving the UNAIDS 2020 target of 90-90-90. METHODS: In 2014, data were collected from 24 Central and Eastern European countries using a 38-item questionnaire. RESULTS: All countries reported mandatory screening of blood and organ donors for HIV. Other groups subjected to targeted screening included people who inject drugs (PWID) (15/24, 62.5%), men who have sex with men (MSM) (14/24, 58.3%), and sex workers (12/24, 50.0%). Only 14 of the 24 countries (58.3%) screened pregnant women. The percentages of late presentation and advanced disease were 40.3% (range 14-80%) and 25.4% (range 9-50%), respectively. There was no difference between countries categorized by income or by region in terms of the percentages of persons presenting late or with advanced disease. The availability of newer antiretroviral drugs (rilpivirine, etravirine, darunavir, maraviroc, raltegravir, dolutegravir) tended to be significantly better with a higher country income status. Ten countries reported initiating antiretroviral therapy (ART) regardless of CD4+ T cell count (41.7%), five countries (20.8%) used the threshold of <500 cells/μl, and nine countries (37.5%) used the threshold of <350cells/μl. Initiation of ART regardless of the CD4+ T cell count was significantly more common among high-income countries than among upper-middle-income and lower-middle-income countries (100% vs. 27.3% and 0%, respectively; p=0.001). Drugs were provided free of charge in all countries and mostly provided by governments. There were significant discrepancies between countries regarding the follow-up of people living with HIV. CONCLUSIONS: There are major disparities in the provision of HIV care among sub-regions in Europe, which should be addressed. More attention in terms of funding, knowledge and experience sharing, and capacity building is required for the resource-limited settings of Central and Eastern Europe. The exact needs should be defined and services scaled up in order to achieve a standard level of care and provide an adequate and sustainable response to the HIV epidemic in this region.
Authors: Agata Skrzat-Klapaczyńska; Justyna D Kowalska; Larisa Afonina; Svitlana Antonyak; Tatevik Balayan; Josip Begovac; Dominik Bursa; Gordana Dragovic; Deniz Gokengin; Arjan Harxhi; David Jilich; Kerstin Kase; Botond Lakatos; Mariana Mardarescu; Raimonda Matulionyte; Cristiana Oprea; Aleksandr Panteleev; Antonios Papadopoulos; Lubomir Sojak; Janez Tomazic; Anna Vassilenko; Marta Vasylyev; Antonija Verhaz; Nina Yancheva; Oleg Yurin; Andrzej Horban Journal: Int J Environ Res Public Health Date: 2022-06-21 Impact factor: 4.614
Authors: Anca Streinu-Cercel; Oana Săndulescu; Cătălina Poiană; Maria Dorobanţu; Gabriel Mircescu; Voichiţa Elena Lăzureanu; Irina-Magdalena Dumitru; Odette Chirilă; Adrian Streinu-Cercel Journal: Germs Date: 2019-12-02
Authors: J D Kowalska; A Skrzat-Klapaczyńska; D Bursa; T Balayan; J Begovac; N Chkhartishvili; D Gokengin; A Harxhi; D Jilich; D Jevtovic; K Kase; B Lakatos; R Matulionyte; V Mulabdic; A Nagit; A Papadopoulos; M Stefanovic; A Vassilenko; M Vasylyev; N Yancheva; O Yurin; A Horban Journal: Int J Infect Dis Date: 2020-05-11 Impact factor: 3.623
Authors: Immaculate M Langmia; Katja S Just; Sabrina Yamoune; Jürgen Brockmöller; Collen Masimirembwa; Julia C Stingl Journal: Front Genet Date: 2021-07-12 Impact factor: 4.599