Healthcare delivery for HIV-positive people with tuberculosis in Europe.

Antitubercular Agents / therapeutic use Delivery of Health Care Europe / epidemiology HIV Infections / complications Humans Tuberculosis / diagnosis

HIV clinical management coinfection eastern Europe tuberculosis western Europe

Journal

HIV medicine

ISSN: 1468-1293

Titre abrégé: HIV Med

Pays: England

ID NLM: 100897392

Informations de publication

Date de publication:
04 2021

Historique:

accepted: 12 10 2020

pubmed: 21 11 2020

medline: 15 3 2022

entrez: 20 11 2020

Statut: ppublish

Résumé

In a 2013 survey, we reported distinct discrepancies in delivery of tuberculosis (TB) and HIV services in eastern Europe (EE) vs. western Europe (WE). To verify the differences in TB and HIV services in EE vs. WE. Twenty-three sites completed a survey in 2018 (EE, 14; WE, nine; 88% response rate). Results were compared across as well as within the two regions. When possible, results were compared with the 2013 survey. Delivery of healthcare was significantly less integrated in EE: provision of TB and HIV services at one site (36% in EE vs. 89% in WE; P = 0.034), and continued TB follow-up in one location (42% vs. 100%; P = 0.007). Although access to TB diagnostics, standard TB and HIV drugs was generally good, fewer sites in EE reported unlimited access to rifabutin/multi-drug-resistant TB (MDR-TB) drugs, HIV integrase inhibitors and opioid substitution therapy (OST). Compared with 2013, routine usage of GeneXpert was more common in EE in 2018 (54% vs. 92%; P = 0.073), as was access to moxifloxacin (46% vs. 91%; P = 0.033), linezolid (31% vs. 64%; P = 0.217), and bedaquiline (0% vs. 25%; P = 0.217). Integration of TB and HIV services (46% vs. 39%; P = 1.000) and provision of OST to patients with opioid dependency (54% vs. 46%; P = 0.695) remained unchanged. Delivery of TB and HIV healthcare, including integration of TB and HIV care and access to MDR-TB drugs, still differs between WE and EE, as well as between individual EE sites.

Sections du résumé

BACKGROUND

In a 2013 survey, we reported distinct discrepancies in delivery of tuberculosis (TB) and HIV services in eastern Europe (EE) vs. western Europe (WE).

OBJECTIVES

To verify the differences in TB and HIV services in EE vs. WE.

METHODS

Twenty-three sites completed a survey in 2018 (EE, 14; WE, nine; 88% response rate). Results were compared across as well as within the two regions. When possible, results were compared with the 2013 survey.

RESULTS

Delivery of healthcare was significantly less integrated in EE: provision of TB and HIV services at one site (36% in EE vs. 89% in WE; P = 0.034), and continued TB follow-up in one location (42% vs. 100%; P = 0.007). Although access to TB diagnostics, standard TB and HIV drugs was generally good, fewer sites in EE reported unlimited access to rifabutin/multi-drug-resistant TB (MDR-TB) drugs, HIV integrase inhibitors and opioid substitution therapy (OST). Compared with 2013, routine usage of GeneXpert was more common in EE in 2018 (54% vs. 92%; P = 0.073), as was access to moxifloxacin (46% vs. 91%; P = 0.033), linezolid (31% vs. 64%; P = 0.217), and bedaquiline (0% vs. 25%; P = 0.217). Integration of TB and HIV services (46% vs. 39%; P = 1.000) and provision of OST to patients with opioid dependency (54% vs. 46%; P = 0.695) remained unchanged.

CONCLUSION

Delivery of TB and HIV healthcare, including integration of TB and HIV care and access to MDR-TB drugs, still differs between WE and EE, as well as between individual EE sites.

Identifiants

DOI: 10.1111/hiv.13016 PMID: 33215809 PMC: PMC9801686

pubmed: 33215809

doi: 10.1111/hiv.13016

pmc: PMC9801686

mid: NIHMS1854916

doi:

Substances chimiques

Antitubercular Agents 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Pagination

283-293

Subventions

Organisme : FIC NIH HHS

ID : D43 TW007124

Pays : United States

Organisme : Medical Research Council

ID : MR/T001127/1

Pays : United Kingdom

Organisme : Department of Health

ID : RP-2016-07-012

Pays : United Kingdom

Investigateurs

I Karpov (I)

A Vassilenko (A)

D Klimuk (D)

A Skrahin (A)

O Kondratenko (O)

A Zalutskaya (A)

V Bondarenko (V)

E Kozorez (E)

O Tumash (O)

O Suetnov (O)

V Iljina (V)

T Kummik (T)

K Mshvidobadze (K)

N Lanchava (N)

L Goginashvili (L)

L Mikiashvili (L)

N Bablishvili (N)

B Rozentale (B)

I Zeltina (I)

I Janushkevich (I)

I Caplinskiene (I)

S Caplinskas (S)

A Wiercinska-Drapalo (A)

M Thompson (M)

J Kozlowska (J)

M Bura (M)

B Knysz (B)

A Garlicki (A)

J Loster (J)

D Duiculescu (D)

A Rakhmanova (A)

O Panteleeva (O)

A Yakovlev (A)

A Kozlov (A)

A Tyukalova (A)

Y Vlasova (Y)

T Trofimov (T)

G Kyselyova (G)

N Obel (N)

J Gerstoft (J)

G Kronborg (G)

M C Payen (MC)

K Kabeya (K)

C Necsoi (C)

F Dabis (F)

A Tsaranazy (A)

C Cazanave (C)

H Furrer (H)

M Sagette (M)

M Rickenbach (M)

L Elzi (L)

M Battegay (M)

H Furrer (H)

D Sculier (D)

A Calmy (A)

M Cavassini (M)

A Bruno (A)

E Bernasconi (E)

M Hoffmann (M)

P Vernazza (P)

J Fehr (J)

R Weber (R)

N Vora (N)

G Cooke (G)

S Mullaney (S)

E Wilkins (E)

V George (V)

P Collini (P)

D Dockrell (D)

L Campbell (L)

R Brum (R)

E Mabonga (E)

P Saigal (P)

S Kegg (S)

J Ainsworth (J)

A Waters (A)

J Dhar (J)

K Ellis (K)

Ospedale L Spallanzani (OL)

E Girardi (E)

A Rianda (A)

V Galati (V)

C Pinnetti (C)

C Tommasi (C)

A O San Gerardo (AO)

G Lapadula (G)

A Di Biagio (A)

A Parisini (A)

S Carbonara (S)

G Angarano (G)

M Purgatorio (M)

A Matteelli (A)

A Apostoli (A)

J M Miro (JM)

C Manzardo (C)

C Ligero (C)

J Gonzalez (J)

Jose A Martinez-Martinez (JA)

F Sanchez (F)

H Knobel (H)

M Salvadó (M)

J L Lopez-Colomes (JL)

X Martínez-Lacasa (X)

E Cuchí (E)

V Falcó (V)

A Curran (A)

M T Tortola (MT)

I Ocaña (I)

R Vidal (R)

M A Sambeat (MA)

V Pomar (V)

P Coll (P)

D Pozamczer (D)

M Saumoy (M)

F Alcaide (F)

J Caylà (J)

A Moreno (A)

J P Millet (JP)

A Orcau (A)

L Fina (L)

A Romero (A)

L L Roldan (LL)

J A Iribarren (JA)

M Ibarguren (M)

S Moreno (S)

A González (A)

P Miralles (P)

T Aldámiz-Echevarría (T)

M Losso (M)

J Toibaro (J)

L Gambardella (L)

J M Ramos Mejía (JM)

J Toibaro (J)

L Moreno Macias (L)

E Warley (E)

S Tavella (S)

O Garcia Messina (O)

O Gear (O)

H Laplume (H)

C Marson (C)

J Contarelia (J)

M Michaan (M)

P Scapellato (P)

B Bartoletti (B)

D Palmero (D)

C Elias (C)

C Cortes (C)

B Crabtree (B)

J L Mosqueda Gomez (JL)

J A Villanueva (JA)

L A Gonzalez Hernandez (LA)

F Badial (F)

Informations de copyright

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