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1. Healthcare delivery for HIV-positive people with tuberculosis in Europe

Author

Bentzon, A, 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, J, Inglot, M, Podlekareva, D, Bolokadze, N, Kirk, O, Karpov, I, Vassilenko, A, Klimuk, D, Skrahin, A, Kondratenko, O, Zalutskaya, A, Bondarenko, V, Kozorez, E, Tumash, O, Suetnov, O, Iljina, V, Kummik, T, Mshvidobadze, K, Lanchava, N, Goginashvili, L, Mikiashvili, L, Bablishvili, N, Rozentale, B, Zeltina, I, Janushkevich, I, Caplinskiene, I, Caplinskas, S, Wiercinska-Drapalo, A, Thompson, M, Kozlowska, J, Bura, M, Knysz, B, Garlicki, A, Loster, J, Duiculescu, D, Rakhmanova, A, Panteleeva, O, Yakovlev, A, Kozlov, A, Tyukalova, A, Vlasova, Y, Trofimov, T, Kyselyova, G, Obel, N, Gerstoft, J, Kronborg, G, Payen, M, Kabeya, K, Necsoi, C, Dabis, F, Tsaranazy, A, Cazanave, C, Furrer, H, Sagette, M, Rickenbach, M, Elzi, L, Battegay, M, Sculier, D, Calmy, A, Cavassini, M, Bruno, A, Bernasconi, E, Hoffmann, M, Vernazza, P, Fehr, J, Weber, R, Vora, N, Cooke, G, Mullaney, S, Wilkins, E, George, V, Collini, P, Dockrell, D, Campbell, L, Brum, R, Mabonga, E, Saigal, P, Kegg, S, Ainsworth, J, Waters, A, Dhar, J, Ellis, K, Spallanzani, O, Girardi, E, Rianda, A, Galati, V, Pinnetti, C, Tommasi, C, San Gerardo, A, Lapadula, G, Di Biagio, A, Parisini, A, Carbonara, S, Angarano, G, Purgatorio, M, Matteelli, A, Apostoli, A, Miro, J, Manzardo, C, Ligero, C, Gonzalez, J, Martinez-Martinez, J, Sanchez, F, Knobel, H, Salvado, M, Lopez-Colomes, J, Martinez-Lacasa, X, Cuchi, E, Falco, V, Curran, A, Tortola, M, Ocana, I, Vidal, R, Sambeat, M, Pomar, V, Coll, P, Pozamczer, D, Saumoy, M, Alcaide, F, Cayla, J, Moreno, A, Millet, J, Orcau, A, Fina, L, Romero, A, Roldan, L, Iribarren, J, Ibarguren, M, Moreno, S, Gonzalez, A, Miralles, P, Aldamiz-Echevarria, T, Losso, M, Toibaro, J, Gambardella, L, Ramos Mejia, J, Moreno Macias, L, Warley, E, Tavella, S, Garcia Messina, O, Gear, O, Laplume, H, Marson, C, Contarelia, J, Michaan, M, Scapellato, P, Bartoletti, B, Palmero, D, Elias, C, Cortes, C, Crabtree, B, Mosqueda Gomez, J, Villanueva, J, Gonzalez Hernandez, L, Badial, F, Bentzon A. K., 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 J. D., Inglot M., Podlekareva D., Bolokadze N., Kirk O., Karpov I., Vassilenko A., Klimuk D., Skrahin A., Kondratenko O., Zalutskaya A., Bondarenko V., Kozorez E., Tumash O., Suetnov O., Iljina V., Kummik T., Mshvidobadze K., Lanchava N., Goginashvili L., Mikiashvili L., Bablishvili N., Rozentale B., Zeltina I., Janushkevich I., Caplinskiene I., Caplinskas S., Wiercinska-Drapalo A., Thompson M., Kozlowska J., Bura M., Knysz B., Garlicki A., Loster J., Duiculescu D., Rakhmanova A., Panteleeva O., Yakovlev A., Kozlov A., Tyukalova A., Vlasova Y., Trofimov T., Kyselyova G., Obel N., Gerstoft J., Kronborg G., Payen M. C., Kabeya K., Necsoi C., Dabis F., Tsaranazy A., Cazanave C., Furrer H., Sagette M., Rickenbach M., Elzi L., Battegay M., Sculier D., Calmy A., Cavassini M., Bruno A., Bernasconi E., Hoffmann M., Vernazza P., Fehr J., Weber R., Vora N., Cooke G., Mullaney S., Wilkins E., George V., Collini P., Dockrell D., Campbell L., Brum R., Mabonga E., Saigal P., Kegg S., Ainsworth J., Waters A., Dhar J., Ellis K., Spallanzani O. L., Girardi E., Rianda A., Galati V., Pinnetti C., Tommasi C., San Gerardo A. O., Lapadula G., Di Biagio A., Parisini A., Carbonara S., Angarano G., Purgatorio M., Matteelli A., Apostoli A., Miro J. M., Manzardo C., Ligero C., Gonzalez J., Martinez-Martinez J. A., Sanchez F., Knobel H., Salvado M., Lopez-Colomes J. L., Martinez-Lacasa X., Cuchi E., Falco V., Curran A., Tortola M. T., Ocana I., Vidal R., Sambeat M. A., Pomar V., Coll P., Pozamczer D., Saumoy M., Alcaide F., Cayla J., Moreno A., Millet J. P., Orcau A., Fina L., Romero A., Roldan L. L., Iribarren J. A., Ibarguren M., Moreno S., Gonzalez A., Miralles P., Aldamiz-Echevarria T., Losso M., Toibaro J., Gambardella L., Ramos Mejia J. M., Moreno Macias L., Warley E., Tavella S., Garcia Messina O., Gear O., Laplume H., Marson C., Contarelia J., Michaan M., Scapellato P., Bartoletti B., Palmero D., Elias C., Cortes C., Crabtree B., Mosqueda Gomez J. L., Villanueva J. A., Gonzalez Hernandez L. A., Badial F., Bentzon, A, 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, J, Inglot, M, Podlekareva, D, Bolokadze, N, Kirk, O, Karpov, I, Vassilenko, A, Klimuk, D, Skrahin, A, Kondratenko, O, Zalutskaya, A, Bondarenko, V, Kozorez, E, Tumash, O, Suetnov, O, Iljina, V, Kummik, T, Mshvidobadze, K, Lanchava, N, Goginashvili, L, Mikiashvili, L, Bablishvili, N, Rozentale, B, Zeltina, I, Janushkevich, I, Caplinskiene, I, Caplinskas, S, Wiercinska-Drapalo, A, Thompson, M, Kozlowska, J, Bura, M, Knysz, B, Garlicki, A, Loster, J, Duiculescu, D, Rakhmanova, A, Panteleeva, O, Yakovlev, A, Kozlov, A, Tyukalova, A, Vlasova, Y, Trofimov, T, Kyselyova, G, Obel, N, Gerstoft, J, Kronborg, G, Payen, M, Kabeya, K, Necsoi, C, Dabis, F, Tsaranazy, A, Cazanave, C, Furrer, H, Sagette, M, Rickenbach, M, Elzi, L, Battegay, M, Sculier, D, Calmy, A, Cavassini, M, Bruno, A, Bernasconi, E, Hoffmann, M, Vernazza, P, Fehr, J, Weber, R, Vora, N, Cooke, G, Mullaney, S, Wilkins, E, George, V, Collini, P, Dockrell, D, Campbell, L, Brum, R, Mabonga, E, Saigal, P, Kegg, S, Ainsworth, J, Waters, A, Dhar, J, Ellis, K, Spallanzani, O, Girardi, E, Rianda, A, Galati, V, Pinnetti, C, Tommasi, C, San Gerardo, A, Lapadula, G, Di Biagio, A, Parisini, A, Carbonara, S, Angarano, G, Purgatorio, M, Matteelli, A, Apostoli, A, Miro, J, Manzardo, C, Ligero, C, Gonzalez, J, Martinez-Martinez, J, Sanchez, F, Knobel, H, Salvado, M, Lopez-Colomes, J, Martinez-Lacasa, X, Cuchi, E, Falco, V, Curran, A, Tortola, M, Ocana, I, Vidal, R, Sambeat, M, Pomar, V, Coll, P, Pozamczer, D, Saumoy, M, Alcaide, F, Cayla, J, Moreno, A, Millet, J, Orcau, A, Fina, L, Romero, A, Roldan, L, Iribarren, J, Ibarguren, M, Moreno, S, Gonzalez, A, Miralles, P, Aldamiz-Echevarria, T, Losso, M, Toibaro, J, Gambardella, L, Ramos Mejia, J, Moreno Macias, L, Warley, E, Tavella, S, Garcia Messina, O, Gear, O, Laplume, H, Marson, C, Contarelia, J, Michaan, M, Scapellato, P, Bartoletti, B, Palmero, D, Elias, C, Cortes, C, Crabtree, B, Mosqueda Gomez, J, Villanueva, J, Gonzalez Hernandez, L, Badial, F, Bentzon A. K., 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 J. D., Inglot M., Podlekareva D., Bolokadze N., Kirk O., Karpov I., Vassilenko A., Klimuk D., Skrahin A., Kondratenko O., Zalutskaya A., Bondarenko V., Kozorez E., Tumash O., Suetnov O., Iljina V., Kummik T., Mshvidobadze K., Lanchava N., Goginashvili L., Mikiashvili L., Bablishvili N., Rozentale B., Zeltina I., Janushkevich I., Caplinskiene I., Caplinskas S., Wiercinska-Drapalo A., Thompson M., Kozlowska J., Bura M., Knysz B., Garlicki A., Loster J., Duiculescu D., Rakhmanova A., Panteleeva O., Yakovlev A., Kozlov A., Tyukalova A., Vlasova Y., Trofimov T., Kyselyova G., Obel N., Gerstoft J., Kronborg G., Payen M. C., Kabeya K., Necsoi C., Dabis F., Tsaranazy A., Cazanave C., Furrer H., Sagette M., Rickenbach M., Elzi L., Battegay M., Sculier D., Calmy A., Cavassini M., Bruno A., Bernasconi E., Hoffmann M., Vernazza P., Fehr J., Weber R., Vora N., Cooke G., Mullaney S., Wilkins E., George V., Collini P., Dockrell D., Campbell L., Brum R., Mabonga E., Saigal P., Kegg S., Ainsworth J., Waters A., Dhar J., Ellis K., Spallanzani O. L., Girardi E., Rianda A., Galati V., Pinnetti C., Tommasi C., San Gerardo A. O., Lapadula G., Di Biagio A., Parisini A., Carbonara S., Angarano G., Purgatorio M., Matteelli A., Apostoli A., Miro J. M., Manzardo C., Ligero C., Gonzalez J., Martinez-Martinez J. A., Sanchez F., Knobel H., Salvado M., Lopez-Colomes J. L., Martinez-Lacasa X., Cuchi E., Falco V., Curran A., Tortola M. T., Ocana I., Vidal R., Sambeat M. A., Pomar V., Coll P., Pozamczer D., Saumoy M., Alcaide F., Cayla J., Moreno A., Millet J. P., Orcau A., Fina L., Romero A., Roldan L. L., Iribarren J. A., Ibarguren M., Moreno S., Gonzalez A., Miralles P., Aldamiz-Echevarria T., Losso M., Toibaro J., Gambardella L., Ramos Mejia J. M., Moreno Macias L., Warley E., Tavella S., Garcia Messina O., Gear O., Laplume H., Marson C., Contarelia J., Michaan M., Scapellato P., Bartoletti B., Palmero D., Elias C., Cortes C., Crabtree B., Mosqueda Gomez J. L., Villanueva J. A., Gonzalez Hernandez L. A., and Badial F.

Abstract

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.

Published
2021

2. Delayed diagnosis of tuberculosis in persons living with HIV in Eastern Europe: associated factors and effect on mortality—a multicentre prospective cohort study

Author

Kraef, C, Bentzon, A, Panteleev, A, Skrahina, A, Bolokadze, N, Tetradov, S, Podlasin, R, Karpov, I, Borodulina, E, Denisova, E, Azina, I, Lundgren, J, Johansen, I, Mocroft, A, Podlekareva, D, Kirk, O, Vassilenko, A, Klimuk, D, Kondratenko, O, Zalutskaya, A, Bondarenko, V, Mitsura, V, Kozorez, E, Tumash, O, Suetnov, O, Paduto, D, Iljina, V, Kummik, T, Mshvidobadze, K, Lanchava, N, Goginashvili, L, Mikiashvili, L, Bablishvili, N, Rozentale, B, Zeltina, I, Janushkevich, I, Caplinskiene, I, Caplinskas, S, Kancauskiene, Z, Wiercinska-Drapalo, A, Thompson, M, Kozlowska, J, Grezesczuk, A, Bura, M, Knysz, B, Inglot, M, Garlicki, A, Loster, J, Uiculescu, D, Rakhmanova, A, Panteleev, O, Yakovlev, A, Kozlov, A, Tyukalova, A, Vlasova, Y, Rofimov, T, Kyselyova, G, Obel, N, Gerstoft, J, Kronborg, G, Payen, M, Abeya, K, Necsoi, C, Dabis, F, Tsaranazy, A, Cazanave, C, Furrer, H, Sagette, M, Rickenbach, M, Sculier, D, Calmy, A, Cavassini, M, Bruno, A, Bernasconi, E, Hoffmann, M, Vernazza, P, Fehr, J, Weber, R, Miller, R, Vora, N, Cooke, G, Mullaney, S, Wilkins, E, George, V, Collini, P, Dockrell, D, Post, F, Campbell, L, Brum, R, Mabonga, E, Saigal, P, Kegg, S, Ainsworth, J, Waters, A, Dhar, J, Ellis, K, Girardi, E, Rianda, A, Galati, V, Pinnetti, C, Tommasi, C, Lapadula, G, Di Biagio, A, Parisini, A, Carbonara, S, Angarano, G, Purgatorio, M, Matteelli, A, Apostoli, A, Miro, J, Manzardo, C, Ligero, C, Gonzalez, J, Martinez-Martinez, J, Sanchez, F, Knobel, H, Salvado, M, Lopez-Colomes, J, Martinez-Lacasa, X, Cuchi, E, Falco, V, Curran, A, Tortola, M, Ocana, I, Vidal, R, Sambeat, M, Pomar, V, Coll, P, Pozamczer, D, Saumoy, M, Alcaide, F, Cayla, J, Moreno, A, Millet, J, Orcau, A, Fina, L, Romero, A, Roldan, L, Iribarren, J, Ibarguren, M, Moreno, S, Gonzalez, A, Miralles, P, Aldamiz-Echevarria, T, Losso, M, Toibaro, J, Gambardella, L, Moreno Macias, L, Warley, E, Tavella, S, Garcia Messina, O, Gear, O, Laplume, H, Marson, C, Contarelia, J, Michaan, M, Scapellato, P, Bartoletti, B, Palmero, D, Elias, C, Cortes, C, Crabtree, B, Mosqueda Gomez, J, Villanueva, J, Gonzalez Hernandez, L, Badial, F, Kraef C., Bentzon A., Panteleev A., Skrahina A., Bolokadze N., Tetradov S., Podlasin R., Karpov I., Borodulina E., Denisova E., Azina I., Lundgren J., Johansen I. S., Mocroft A., Podlekareva D., Kirk O., Vassilenko A., Klimuk D., Kondratenko O., Zalutskaya A., Bondarenko V., Mitsura V., Kozorez E., Tumash O., Suetnov O., Paduto D., Iljina V., Kummik T., Mshvidobadze K., Lanchava N., Goginashvili L., Mikiashvili L., Bablishvili N., Rozentale B., Zeltina I., Janushkevich I., Caplinskiene I., Caplinskas S., Kancauskiene Z., Wiercinska-Drapalo A., Thompson M., Kozlowska J., Grezesczuk A., Bura M., Knysz B., Inglot M., Garlicki A., Loster J., uiculescu D. D., Rakhmanova A., Panteleev O., Yakovlev A., Kozlov A., Tyukalova A., Vlasova Y., rofimov T. T., Kyselyova G., Obel N., Gerstoft J., Kronborg G., Payen M. C., abeya K. K., Necsoi C., Dabis F., Tsaranazy A., Cazanave C., Furrer H., Sagette M., Rickenbach M., Sculier D., Calmy A., Cavassini M., Bruno A., Bernasconi E., Hoffmann M., Vernazza P., Fehr J., Weber R., Miller R., Vora N., Cooke G., Mullaney S., Wilkins E., George V., Collini P., Dockrell D., Post F., Campbell L., Brum R., Mabonga E., Saigal P., Kegg S., Ainsworth J., Waters A., Dhar J., Ellis K., Girardi E., Rianda A., Galati V., Pinnetti C., Tommasi C., Lapadula G., Di Biagio A., Parisini A., Carbonara S., Angarano G., Purgatorio M., Matteelli A., Apostoli A., Miro J. M., Manzardo C., Ligero C., Gonzalez J., Martinez-Martinez J. A., Sanchez F., Knobel H., Salvado M., Lopez-Colomes J. L., Martinez-Lacasa X., Cuchi E., Falco V., Curran A., Tortola M. T., Ocana I., Vidal R., Sambeat M. A., Pomar V., Coll P., Pozamczer D., Saumoy M., Alcaide F., Cayla J., Moreno A., Millet J. P., Orcau A., Fina L., Romero A., Roldan L. L., Iribarren J. A., Ibarguren M., Moreno S., Gonzalez A., Miralles P., Aldamiz-Echevarria T., Losso M., Toibaro J., Gambardella L., Moreno Macias L., Warley E., Tavella S., Garcia Messina O., Gear O., Laplume H., Marson C., Contarelia J., Michaan M., Scapellato P., Bartoletti B., Palmero D., Elias C., Cortes C., Crabtree B., Mosqueda Gomez J. L., Villanueva J. A., Gonzalez Hernandez L. A., Badial F., Kraef, C, Bentzon, A, Panteleev, A, Skrahina, A, Bolokadze, N, Tetradov, S, Podlasin, R, Karpov, I, Borodulina, E, Denisova, E, Azina, I, Lundgren, J, Johansen, I, Mocroft, A, Podlekareva, D, Kirk, O, Vassilenko, A, Klimuk, D, Kondratenko, O, Zalutskaya, A, Bondarenko, V, Mitsura, V, Kozorez, E, Tumash, O, Suetnov, O, Paduto, D, Iljina, V, Kummik, T, Mshvidobadze, K, Lanchava, N, Goginashvili, L, Mikiashvili, L, Bablishvili, N, Rozentale, B, Zeltina, I, Janushkevich, I, Caplinskiene, I, Caplinskas, S, Kancauskiene, Z, Wiercinska-Drapalo, A, Thompson, M, Kozlowska, J, Grezesczuk, A, Bura, M, Knysz, B, Inglot, M, Garlicki, A, Loster, J, Uiculescu, D, Rakhmanova, A, Panteleev, O, Yakovlev, A, Kozlov, A, Tyukalova, A, Vlasova, Y, Rofimov, T, Kyselyova, G, Obel, N, Gerstoft, J, Kronborg, G, Payen, M, Abeya, K, Necsoi, C, Dabis, F, Tsaranazy, A, Cazanave, C, Furrer, H, Sagette, M, Rickenbach, M, Sculier, D, Calmy, A, Cavassini, M, Bruno, A, Bernasconi, E, Hoffmann, M, Vernazza, P, Fehr, J, Weber, R, Miller, R, Vora, N, Cooke, G, Mullaney, S, Wilkins, E, George, V, Collini, P, Dockrell, D, Post, F, Campbell, L, Brum, R, Mabonga, E, Saigal, P, Kegg, S, Ainsworth, J, Waters, A, Dhar, J, Ellis, K, Girardi, E, Rianda, A, Galati, V, Pinnetti, C, Tommasi, C, Lapadula, G, Di Biagio, A, Parisini, A, Carbonara, S, Angarano, G, Purgatorio, M, Matteelli, A, Apostoli, A, Miro, J, Manzardo, C, Ligero, C, Gonzalez, J, Martinez-Martinez, J, Sanchez, F, Knobel, H, Salvado, M, Lopez-Colomes, J, Martinez-Lacasa, X, Cuchi, E, Falco, V, Curran, A, Tortola, M, Ocana, I, Vidal, R, Sambeat, M, Pomar, V, Coll, P, Pozamczer, D, Saumoy, M, Alcaide, F, Cayla, J, Moreno, A, Millet, J, Orcau, A, Fina, L, Romero, A, Roldan, L, Iribarren, J, Ibarguren, M, Moreno, S, Gonzalez, A, Miralles, P, Aldamiz-Echevarria, T, Losso, M, Toibaro, J, Gambardella, L, Moreno Macias, L, Warley, E, Tavella, S, Garcia Messina, O, Gear, O, Laplume, H, Marson, C, Contarelia, J, Michaan, M, Scapellato, P, Bartoletti, B, Palmero, D, Elias, C, Cortes, C, Crabtree, B, Mosqueda Gomez, J, Villanueva, J, Gonzalez Hernandez, L, Badial, F, Kraef C., Bentzon A., Panteleev A., Skrahina A., Bolokadze N., Tetradov S., Podlasin R., Karpov I., Borodulina E., Denisova E., Azina I., Lundgren J., Johansen I. S., Mocroft A., Podlekareva D., Kirk O., Vassilenko A., Klimuk D., Kondratenko O., Zalutskaya A., Bondarenko V., Mitsura V., Kozorez E., Tumash O., Suetnov O., Paduto D., Iljina V., Kummik T., Mshvidobadze K., Lanchava N., Goginashvili L., Mikiashvili L., Bablishvili N., Rozentale B., Zeltina I., Janushkevich I., Caplinskiene I., Caplinskas S., Kancauskiene Z., Wiercinska-Drapalo A., Thompson M., Kozlowska J., Grezesczuk A., Bura M., Knysz B., Inglot M., Garlicki A., Loster J., uiculescu D. D., Rakhmanova A., Panteleev O., Yakovlev A., Kozlov A., Tyukalova A., Vlasova Y., rofimov T. T., Kyselyova G., Obel N., Gerstoft J., Kronborg G., Payen M. C., abeya K. K., Necsoi C., Dabis F., Tsaranazy A., Cazanave C., Furrer H., Sagette M., Rickenbach M., Sculier D., Calmy A., Cavassini M., Bruno A., Bernasconi E., Hoffmann M., Vernazza P., Fehr J., Weber R., Miller R., Vora N., Cooke G., Mullaney S., Wilkins E., George V., Collini P., Dockrell D., Post F., Campbell L., Brum R., Mabonga E., Saigal P., Kegg S., Ainsworth J., Waters A., Dhar J., Ellis K., Girardi E., Rianda A., Galati V., Pinnetti C., Tommasi C., Lapadula G., Di Biagio A., Parisini A., Carbonara S., Angarano G., Purgatorio M., Matteelli A., Apostoli A., Miro J. M., Manzardo C., Ligero C., Gonzalez J., Martinez-Martinez J. A., Sanchez F., Knobel H., Salvado M., Lopez-Colomes J. L., Martinez-Lacasa X., Cuchi E., Falco V., Curran A., Tortola M. T., Ocana I., Vidal R., Sambeat M. A., Pomar V., Coll P., Pozamczer D., Saumoy M., Alcaide F., Cayla J., Moreno A., Millet J. P., Orcau A., Fina L., Romero A., Roldan L. L., Iribarren J. A., Ibarguren M., Moreno S., Gonzalez A., Miralles P., Aldamiz-Echevarria T., Losso M., Toibaro J., Gambardella L., Moreno Macias L., Warley E., Tavella S., Garcia Messina O., Gear O., Laplume H., Marson C., Contarelia J., Michaan M., Scapellato P., Bartoletti B., Palmero D., Elias C., Cortes C., Crabtree B., Mosqueda Gomez J. L., Villanueva J. A., Gonzalez Hernandez L. A., and Badial F.

Abstract

Background: Early diagnosis of tuberculosis (TB) is important to reduce transmission, morbidity and mortality in people living with HIV (PLWH). Methods: PLWH with a diagnosis of TB were enrolled from HIV and TB clinics in Eastern Europe and followed until 24 months. Delayed diagnosis was defined as duration of TB symptoms (cough, weight-loss or fever) for ≥ 1 month before TB diagnosis. Risk factors for delayed TB diagnosis were assessed using multivariable logistic regression. The effect of delayed diagnosis on mortality was assessed using Kaplan–Meier estimates and Cox models. Findings: 480/740 patients (64.9%; 95% CI 61.3–68.3%) experienced a delayed diagnosis. Age ≥ 50 years (vs. < 50 years, aOR = 2.51; 1.18–5.32; p = 0.016), injecting drug use (IDU) (vs. non-IDU aOR = 1.66; 1.21–2.29; p = 0.002), being ART naïve (aOR = 1.77; 1.24–2.54; p = 0.002), disseminated TB (vs. pulmonary TB, aOR = 1.56, 1.10–2.19, p = 0.012), and presenting with weight loss (vs. no weight loss, aOR = 1.63; 1.18–2.24; p = 0.003) were associated with delayed diagnosis. PLWH with a delayed diagnosis were at 36% increased risk of death (hazard ratio = 1.36; 1.04–1.77; p = 0.023, adjusted hazard ratio 1.27; 0.95–1.70; p = 0.103). Conclusion: Nearly two thirds of PLWH with TB in Eastern Europe had a delayed TB diagnosis, in particular those of older age, people who inject drugs, ART naïve, with disseminated disease, and presenting with weight loss. Patients with delayed TB diagnosis were subsequently at higher risk of death in unadjusted analysis. There is a need for optimisation of the current TB diagnostic cascade and HIV care in PLWH in Eastern Europe.

Published
2021

3. Major differences in organization and availability of health care and medicines for HIV/TB coinfected patients across Europe

Author

Mansfeld, M, Skrahina, A, Shepherd, L, Schultze, A, Panteleev, A, Miller, R, Miro, J, Zeltina, I, Tetradov, S, Furrer, H, Kirk, O, Grzeszczuk, A, Bolokadze, N, Matteelli, A, Post, F, Lundgren, J, Mocroft, A, Efsen, A, Podlekareva, D, Losso, M, Toibaro, J, Palmero, D, Bartoletti, B, E., W, Gear, O, Messina, O, Michans, M, Laplume, H, David, D, Marson, C, Scapelatto, F, Dalessandro, D, Lupo, S, Costilla Campero, G, Herbst, M, Remondegui, C, Elias, C, Karpov, I, Vassilenko, A, Skrahina, E, Skrahin, A, Zalutskya, A, Kondratenko, O, Mitsura, V, Bondarenko, V, Suetnov, O, Paduto, D, Dewit, S, Payen, M, Noscoi, C, Kabeya, K, M., W, Cortes, C, Obel, N, Kronborg, G, Iljna, V, Kummik, T, Bryand, M, Dabis, F, Lanchava, N, Bablishvili, N, Goginashvili, L, Mikiashvili, L, Mshvidobadze, K, Girardi, E, Di Biagio, A, Apostoli, A, Barzoni, S, Lapadula, G, Purgatorio, M, Carbonara, S, Rozentale, B, Janushkevich, I, Caplinskas, S, Kancauskienne, Z, Caplinskienne, I, Crabtree, B, Pina, A, Madero, J, Mosqueda, J, Villanueva, J, Bura, M, Garlicki, A, Inglot, M, Knysz, B, Kozlowska, J, Loster, J, Mularska, E, Podlasin, R, Thompson, M, Wiercinska-Drapalo, A, Duiculescu, D, Rakhmanova, A, Yakovlev, A, Turkalova, A, Vlasova, Y, Trotimora, T, Borodulina, E, Chumanova, L, Mashkova, Y, Cayla, J, Moreno, A, Millet, J, Orcau, A, Fina, L, del Bano, L, Roldan, L, Romero, A, Martinez, J, Manzardo, C, Gonzalez, J, Tudo, G, Knobel, H, Sanchez, F, Salvado, M, Curran, A, Tortola, M, Pozamczer, D, Saumoy, M, Alcaide, F, Martinez-Lacasa, X, Cuchi, E, Sambeat, M, Pomar, V, Coll, P, Miralles, P, Moreno, S, Iribarren, J, Ibarguren, M, Aldamiz, T, Rickenbach, M, Sagette, M, Chapman, A, Dockrell, D, Wilkins, E, Cooke, G, Ainsworth, J, Macallen, D, Dhar, J, Vora, N, Mullaney, S, Kegg, S, Kyselyova, G, Mansfeld M., Skrahina A., Shepherd L., Schultze A., Panteleev A., Miller R., Miro J., Zeltina I., Tetradov S., Furrer H., Kirk O., Grzeszczuk A., Bolokadze N., Matteelli A., Post F., Lundgren J., Mocroft A., Efsen A., Podlekareva D., Losso M. H., Toibaro J. J., Palmero D., Bartoletti B. J., E. Warley, Gear O., Messina O. G., Michans M., Laplume H., David D., Marson C., Scapelatto F. P., Dalessandro D., Lupo S., Costilla Campero G., Herbst M., Remondegui C., Elias C., Karpov I., Vassilenko A., Skrahina E., Skrahin A., Zalutskya A., Kondratenko O., Mitsura V., Bondarenko V., Suetnov O., Paduto D., Dewit S., Payen M. C., Noscoi C., Kabeya K., M. Wolff, Cortes C., Obel N., Kronborg G., Iljna V., Kummik T., Bryand M., Dabis F., Lanchava N., Bablishvili N., Goginashvili L., Mikiashvili L., Mshvidobadze K., Girardi E., Di Biagio A., Apostoli A., Barzoni S., Lapadula G., Purgatorio M., Carbonara S., Rozentale B., Janushkevich I., Caplinskas S., Kancauskienne Z., Caplinskienne I., Crabtree B., Pina A., Madero J. S., Mosqueda J., Villanueva J. A., Bura M., Garlicki A., Inglot M., Knysz B., Kozlowska J., Loster J., Mularska E., Podlasin R., Thompson M., Wiercinska-Drapalo A., Duiculescu D., Rakhmanova A., Yakovlev A., Turkalova A., Vlasova Y., Trotimora T., Borodulina E., Chumanova L., Mashkova Y., Miro J. M., Cayla J. A., Moreno A., Millet J. P., Orcau A., Fina L., del Bano L., Roldan L. L., Romero A., Martinez J. A., Manzardo C., Gonzalez J., Tudo G., Knobel H., Sanchez F., Salvado M., Curran A., Tortola M. T., Pozamczer D., Saumoy M., Alcaide F., Martinez-Lacasa X., Cuchi E., Sambeat M. A., Pomar V., Coll P., Miralles P., Moreno S., Iribarren J. A., Ibarguren M., Aldamiz T., Rickenbach M., Sagette M., Post F. A., Miller R. F., Chapman A., Dockrell D., Wilkins E., Cooke G., Ainsworth J., Macallen D., Dhar J., Vora N., Mullaney S., Kegg S., Kyselyova G., Mansfeld, M, Skrahina, A, Shepherd, L, Schultze, A, Panteleev, A, Miller, R, Miro, J, Zeltina, I, Tetradov, S, Furrer, H, Kirk, O, Grzeszczuk, A, Bolokadze, N, Matteelli, A, Post, F, Lundgren, J, Mocroft, A, Efsen, A, Podlekareva, D, Losso, M, Toibaro, J, Palmero, D, Bartoletti, B, E., W, Gear, O, Messina, O, Michans, M, Laplume, H, David, D, Marson, C, Scapelatto, F, Dalessandro, D, Lupo, S, Costilla Campero, G, Herbst, M, Remondegui, C, Elias, C, Karpov, I, Vassilenko, A, Skrahina, E, Skrahin, A, Zalutskya, A, Kondratenko, O, Mitsura, V, Bondarenko, V, Suetnov, O, Paduto, D, Dewit, S, Payen, M, Noscoi, C, Kabeya, K, M., W, Cortes, C, Obel, N, Kronborg, G, Iljna, V, Kummik, T, Bryand, M, Dabis, F, Lanchava, N, Bablishvili, N, Goginashvili, L, Mikiashvili, L, Mshvidobadze, K, Girardi, E, Di Biagio, A, Apostoli, A, Barzoni, S, Lapadula, G, Purgatorio, M, Carbonara, S, Rozentale, B, Janushkevich, I, Caplinskas, S, Kancauskienne, Z, Caplinskienne, I, Crabtree, B, Pina, A, Madero, J, Mosqueda, J, Villanueva, J, Bura, M, Garlicki, A, Inglot, M, Knysz, B, Kozlowska, J, Loster, J, Mularska, E, Podlasin, R, Thompson, M, Wiercinska-Drapalo, A, Duiculescu, D, Rakhmanova, A, Yakovlev, A, Turkalova, A, Vlasova, Y, Trotimora, T, Borodulina, E, Chumanova, L, Mashkova, Y, Cayla, J, Moreno, A, Millet, J, Orcau, A, Fina, L, del Bano, L, Roldan, L, Romero, A, Martinez, J, Manzardo, C, Gonzalez, J, Tudo, G, Knobel, H, Sanchez, F, Salvado, M, Curran, A, Tortola, M, Pozamczer, D, Saumoy, M, Alcaide, F, Martinez-Lacasa, X, Cuchi, E, Sambeat, M, Pomar, V, Coll, P, Miralles, P, Moreno, S, Iribarren, J, Ibarguren, M, Aldamiz, T, Rickenbach, M, Sagette, M, Chapman, A, Dockrell, D, Wilkins, E, Cooke, G, Ainsworth, J, Macallen, D, Dhar, J, Vora, N, Mullaney, S, Kegg, S, Kyselyova, G, Mansfeld M., Skrahina A., Shepherd L., Schultze A., Panteleev A., Miller R., Miro J., Zeltina I., Tetradov S., Furrer H., Kirk O., Grzeszczuk A., Bolokadze N., Matteelli A., Post F., Lundgren J., Mocroft A., Efsen A., Podlekareva D., Losso M. H., Toibaro J. J., Palmero D., Bartoletti B. J., E. Warley, Gear O., Messina O. G., Michans M., Laplume H., David D., Marson C., Scapelatto F. P., Dalessandro D., Lupo S., Costilla Campero G., Herbst M., Remondegui C., Elias C., Karpov I., Vassilenko A., Skrahina E., Skrahin A., Zalutskya A., Kondratenko O., Mitsura V., Bondarenko V., Suetnov O., Paduto D., Dewit S., Payen M. C., Noscoi C., Kabeya K., M. Wolff, Cortes C., Obel N., Kronborg G., Iljna V., Kummik T., Bryand M., Dabis F., Lanchava N., Bablishvili N., Goginashvili L., Mikiashvili L., Mshvidobadze K., Girardi E., Di Biagio A., Apostoli A., Barzoni S., Lapadula G., Purgatorio M., Carbonara S., Rozentale B., Janushkevich I., Caplinskas S., Kancauskienne Z., Caplinskienne I., Crabtree B., Pina A., Madero J. S., Mosqueda J., Villanueva J. A., Bura M., Garlicki A., Inglot M., Knysz B., Kozlowska J., Loster J., Mularska E., Podlasin R., Thompson M., Wiercinska-Drapalo A., Duiculescu D., Rakhmanova A., Yakovlev A., Turkalova A., Vlasova Y., Trotimora T., Borodulina E., Chumanova L., Mashkova Y., Miro J. M., Cayla J. A., Moreno A., Millet J. P., Orcau A., Fina L., del Bano L., Roldan L. L., Romero A., Martinez J. A., Manzardo C., Gonzalez J., Tudo G., Knobel H., Sanchez F., Salvado M., Curran A., Tortola M. T., Pozamczer D., Saumoy M., Alcaide F., Martinez-Lacasa X., Cuchi E., Sambeat M. A., Pomar V., Coll P., Miralles P., Moreno S., Iribarren J. A., Ibarguren M., Aldamiz T., Rickenbach M., Sagette M., Post F. A., Miller R. F., Chapman A., Dockrell D., Wilkins E., Cooke G., Ainsworth J., Macallen D., Dhar J., Vora N., Mullaney S., Kegg S., and Kyselyova G.

Abstract

Objectives: The aim of the study was to investigate the organization and delivery of HIV and tuberculosis (TB) health care and to analyse potential differences between treatment centres in Eastern (EE) and Western Europe (WE). Methods: Thirty-eight European HIV and TB treatment centres participating in the TB:HIV study within EuroCoord completed a survey on health care management for coinfected patients in 2013 (EE: 17 respondents; WE:21; 76% of all TB:HIV centres). Descriptive statistics were obtained for regional comparisons. The reported data on health care strategies were compared with actual clinical practice at patient level via data derived from the TB:HIV study. Results: Respondent centres in EE comprised: Belarus (n=3), Estonia (1), Georgia (1), Latvia (1), Lithuania (1), Poland (4), Romania (1), the Russian Federation (4) and Ukraine (1); those in WE comprised: Belgium (1), Denmark (1), France (1), Italy (7), Spain (2), Switzerland (1) and UK (8). Compared with WE, treatment of HIV and TB in EE are less often located at the same site (47% in EE versus 100% in WE; P<0.001) and less often provided by the same doctors (41% versus 90%, respectively; P=0.002), whereas regular screening of HIV-infected patients for TB (80% versus 40%, respectively; P=0.037) and directly observed treatment (88% versus 20%, respectively; P<0.001) were more common in EE. The reported availability of rifabutin and second- and third-line anti-TB drugs was lower, and opioid substitution therapy (OST) was available at fewer centres in EE compared with WE (53% versus 100%, respectively; P<0.001). Conclusions: Major differences exist between EE and WE in relation to the organization and delivery of health care for HIV/TB-coinfected patients and the availability of anti-TB drugs and OST. Significant discrepancies between reported and actual clinical practices were found in EE.

Published
2015

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