Healthcare delivery for HIV-positive people with tuberculosis in Europe

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...

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Detalles Bibliográficos
Autores: Bentzon, Adrian, Panteleev, Alexander, Mitsura, V., Borodulina, Elena, Skrahin, Aliaksandr, Denisova, Elena, Tetradov, Simona, Podlasin, Regina, Riekstina, V., Kancauskiene, Z., Paduto, D., Mocroft, Amanda, Trofimova, T., Miller, Robert F., Post, F., Grzeszczuk, Anna, Lundgren, Jens D., Inglot, M., Podlekareva, Daria N., Bolokadze, N., Kirk, Ole, TB:HIV Study Group., Miró Meda, José M. (José María), 1956-
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2020
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/185963
Acceso en línea:https://hdl.handle.net/2445/185963
Access Level:acceso abierto
Palabra clave:Tuberculosi
VIH (Virus)
Epidemiologia
Europa
Tuberculosis
HIV (Viruses)
Epidemiology
Europe
Descripción
Sumario: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.

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