HIV care in Central and Eastern Europe: How close are we to the target?

• Published in: International journal of infectious diseases 2018-05, Vol.70, p.121-130
• Main Authors: Gokengin, Deniz, Oprea, Cristiana, Begovac, Josip, Horban, Andrzej, Zeka, Arzu Nazlı, Sedlacek, Dalibor, Allabergan, Bayjanov, Almamedova, Esmira A., Balayan, Tatevik, Banhegyi, Denes, Bukovinova, Pavlina, Chkhartishvili, Nikoloz, Damira, Alymbaeva, Deva, Edona, Elenkov, Ivaylo, Gashi, Luljeta, Gexha-Bunjaku, Dafina, Hadciosmanovic, Vesna, Harxhi, Arjan, Holban, Tiberiu, Jevtovic, Djorje, Jilich, David, Kowalska, Justyna, Kuvatova, Djhamal, Ladnaia, Natalya, Mamatkulov, Adkhamjon, Marjanovic, Aleksandra, Nikolova, Maria, Poljak, Mario, Rüütel, Kristi, Shunnar, Azzaden, Stevanovic, Milena, Trumova, Zhanna, Yurin, Oleg
• Format: Article
• Language: English
• Subjects: 90-90-90n targets; Central Europe; Eastern Europe; HIV care
• ISSN: 1201-9712; 1878-3511
• DOI: 10.1016/j.ijid.2018.03.007

•Central and Eastern Europe have maintained an increasing trend in new HIV infections despite the significant decrease globally.•The HIV epidemic in Europe is diverse with major differences between Western, Central and Eastern European countries in terms of HIV care.•Despite the change in guidelines, 12 countries in 2016 still maintained a CD4 T cell count threshold to start antiretroviral treatment.•Central and Eastern Europe requires more attention in terms of knowledge and capacity building for a sustainable response to the HIV epidemic. 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. In 2014, data were collected from 24 Central and Eastern European countries using a 38-item questionnaire. 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