Healthcare delivery for HIV-positive people with tuberculosis in Europe
Por:
Bentzon, AK, Panteleev, A, Mitsura, V, Borodulina, E, Skrahina, A, Denisova, E, Tetradov, S, Podlasin, R, Riekstina, V, Kancauskiene, Z, Paduto, D, Mocroft, A, Trofimova, T, Miller, R, Post, F, Grezesczuk, A, Lundgren, JD, Inglot, M, Podlekareva, D, Bolokadze, N, Kirk, O, Millet J.P., Orcau A., TB HIV Study Grp
Publicada:
1 abr 2021
Ahead of Print:
1 nov 2020
Resumen:
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.
Filiaciones:
Bentzon, AK:
Univ Copenhagen, Rigshosp, Dept Infect Dis, CHIP Ctr Excellence Hlth Immun & Infect, Copenhagen, Denmark
Panteleev, A:
TB Hosp 2, Dept HIV TB, St Petersburg, Russia
Mitsura, V:
Gomel State Med Univ, Gomel, BELARUS
Borodulina, E:
Samara State Med Univ Minzdrav Russia, Dept Phthisiol & Pulmonol, Samara, Russia
Skrahina, A:
Republican Res & Pract Clin Pulmonol, Minsk, BELARUS
Denisova, E:
Botkin Hosp Infect Dis, St Petersburg, Russia
Tetradov, S:
Dr Victor Babes Hosp, Bucharest, Romania
Podlasin, R:
Med Univ Warsaw, Wojewodski Szpital Zakanzy, Warsaw, Poland
Riekstina, V:
Clin TB & Lung Dis, Riga, Latvia
Kancauskiene, Z:
Clin Communicable Dis & AIDS, Vilnius, Lithuania
Paduto, D:
Gomel Reg Clin Hyg, Svetlogorsk, BELARUS
Mocroft, A:
UCL, Dept Infect & Populat Hlth, London, England
Trofimova, T:
Clin Prevent & Control AIDS, Novgorod, Russia
Miller, R:
Mortimer Market Clin, London, England
Post, F:
Kings Coll Hosp London, London, England
Grezesczuk, A:
Med Univ, Teaching Hosp, Bialystok, Poland
Lundgren, JD:
Univ Copenhagen, Rigshosp, Dept Infect Dis, CHIP Ctr Excellence Hlth Immun & Infect, Copenhagen, Denmark
Inglot, M:
Wroclaw Univ, Sch Med, Wroclaw, Poland
Podlekareva, D:
Univ Copenhagen, Rigshosp, Dept Infect Dis, CHIP Ctr Excellence Hlth Immun & Infect, Copenhagen, Denmark
Bolokadze, N:
Infect Dis AIDS & Clin Immunol Res Clin, Tbilisi, Georgia
Kirk, O:
Univ Copenhagen, Rigshosp, Dept Infect Dis, CHIP Ctr Excellence Hlth Immun & Infect, Copenhagen, Denmark
Millet J.P.:
Agència de Salut Pública de Barcelona, Barcelona, Spain
Orcau A.:
Agència de Salut Pública de Barcelona, Barcelona, Spain
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