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Healthcare delivery for HIV‐positive people with tuberculosis in Europe
Author(s) -
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
Publication year - 2021
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.13016
Subject(s) - medicine , genexpert mtb/rif , bedaquiline , tuberculosis , human immunodeficiency virus (hiv) , moxifloxacin , linezolid , health care , family medicine , mycobacterium tuberculosis , antibiotics , vancomycin , economics , economic growth , pathology , genetics , bacteria , microbiology and biotechnology , biology , staphylococcus aureus
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.