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The Capital Region of Denmark - a part of Copenhagen University Hospital
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Healthcare delivery for HIV-positive people with tuberculosis in Europe

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  • A K Bentzon
  • A Panteleev
  • V Mitsura
  • E Borodulina
  • A Skrahina
  • E Denisova
  • S Tetradov
  • R Podlasin
  • V Riekstina
  • Z Kancauskiene
  • D Paduto
  • A Mocroft
  • T Trofimova
  • R Miller
  • F Post
  • A Grezesczuk
  • J D Lundgren
  • M Inglot
  • D Podlekareva
  • N Bolokadze
  • O Kirk
  • TB:HIV Study Group
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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.

Original languageEnglish
JournalHIV Medicine
Volume22
Issue number4
Pages (from-to)283-293
Number of pages11
ISSN1464-2662
DOIs
Publication statusPublished - Apr 2021

    Research areas

  • clinical management, coinfection, eastern Europe, HIV, tuberculosis, western Europe

ID: 61388930