Cross-sectional HIV and HCV cascades of care across the regions of Ukraine between 2019 and 2020: findings from the CARE cohort
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Cross-sectional HIV and HCV cascades of care across the regions of Ukraine between 2019 and 2020 : findings from the CARE cohort. / Fursa, Olga; Reekie, Joanne; Kuzin, Ihor; Hetman, Larysa; Kryshchuk, Alina; Starychenko, Olena; Hrytsaiuk, Nana; Khodus, Inna; Nyzhnyk, Alla; Rakhuba, Viktoriia; Kovalevska, Maryna; Maistat, Tetiana; Pryhoda, Iryna; Ahieieva, Marianna; Varvarovska, Olena; Valdenmaiier, Olena; Lundgren, Jens; Peters, Lars; the CARE study group.
In: Journal of the International AIDS Society, Vol. 26, No. 9, e26166, 2023.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Cross-sectional HIV and HCV cascades of care across the regions of Ukraine between 2019 and 2020
T2 - findings from the CARE cohort
AU - Fursa, Olga
AU - Reekie, Joanne
AU - Kuzin, Ihor
AU - Hetman, Larysa
AU - Kryshchuk, Alina
AU - Starychenko, Olena
AU - Hrytsaiuk, Nana
AU - Khodus, Inna
AU - Nyzhnyk, Alla
AU - Rakhuba, Viktoriia
AU - Kovalevska, Maryna
AU - Maistat, Tetiana
AU - Pryhoda, Iryna
AU - Ahieieva, Marianna
AU - Varvarovska, Olena
AU - Valdenmaiier, Olena
AU - Lundgren, Jens
AU - Peters, Lars
AU - the CARE study group
N1 - Publisher Copyright: © 2023 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of International AIDS Society.
PY - 2023
Y1 - 2023
N2 - Introduction: Eastern Europe is facing major HIV and hepatitis C (HCV) epidemics, with many people living with HIV (PLHIV) and HIV/HCV coinfection living in Ukraine. Despite the previous progress towards care quality improvement, the ongoing war in Ukraine is disrupting HIV and HCV care. Methods: We described an HIV cascade of care (CoC) in PLHIV from two clinical sites and an HCV CoC for anti-HCV-positive PLHIV from six sites in Ukraine, enrolled in the CARE cohort between 1 January 2019 and 1 June 2020. The cross-sectional HIV CoC and HCV CoC are described at study enrolment. Results: Of 1028 PLHIV, 1014 (98.6%, 95% confidence interval [CI] 97.7–99.3) were on antiretroviral therapy (ART), and 876 (86.4% of those on ART, 95% CI 84.1–88.4) were virologically suppressed. Of 894 participants on ART >6 months, 90.8% (95% CI 88.7–92.6) were virologically suppressed (HIV-RNA <200 copies/ml). Of 2040 anti-HCV-positive PLHIV, 417 (20.4%, 95% CI 18.7–22.3) were ever tested for HCV-RNA prior to enrolment, ranging from 4.9% to 54.4% across sites, and 13.5% were currently HCV-RNA positive. One hundred and eighteen persons (7.3% of ever chronically infected) had received HCV treatment, and 25 persons (1.6% of ever chronically infected) were cured, with variations across sites (0%–7.5%). The site diagnosing 54.4% of people with chronic HCV was the only one providing free RNA testing for all anti-HCV-positive persons, while the intra-country differences in treatment coverage were driven by the number of available direct-acting antiviral (DAA) courses. Conclusions: Over 98% of PLHIV in care in both CARE sites in Ukraine were receiving ART, and the target of 90% virally suppressed was achieved in persons >6 months on ART. Only one of six HIV/HCV study sites tested over 50% anti-HCV-positive PLHIV for HCV-RNA and treated over 25% of eligible persons. While free HCV-RNA testing and DAA treatment are paramount to achieving HCV elimination targets, they remained a challenge in Ukraine in 2019–2020. The extent of the HIV and HCV care disruption during the war will be further assessed in the CARE cohort and compared with the pre-war findings.
AB - Introduction: Eastern Europe is facing major HIV and hepatitis C (HCV) epidemics, with many people living with HIV (PLHIV) and HIV/HCV coinfection living in Ukraine. Despite the previous progress towards care quality improvement, the ongoing war in Ukraine is disrupting HIV and HCV care. Methods: We described an HIV cascade of care (CoC) in PLHIV from two clinical sites and an HCV CoC for anti-HCV-positive PLHIV from six sites in Ukraine, enrolled in the CARE cohort between 1 January 2019 and 1 June 2020. The cross-sectional HIV CoC and HCV CoC are described at study enrolment. Results: Of 1028 PLHIV, 1014 (98.6%, 95% confidence interval [CI] 97.7–99.3) were on antiretroviral therapy (ART), and 876 (86.4% of those on ART, 95% CI 84.1–88.4) were virologically suppressed. Of 894 participants on ART >6 months, 90.8% (95% CI 88.7–92.6) were virologically suppressed (HIV-RNA <200 copies/ml). Of 2040 anti-HCV-positive PLHIV, 417 (20.4%, 95% CI 18.7–22.3) were ever tested for HCV-RNA prior to enrolment, ranging from 4.9% to 54.4% across sites, and 13.5% were currently HCV-RNA positive. One hundred and eighteen persons (7.3% of ever chronically infected) had received HCV treatment, and 25 persons (1.6% of ever chronically infected) were cured, with variations across sites (0%–7.5%). The site diagnosing 54.4% of people with chronic HCV was the only one providing free RNA testing for all anti-HCV-positive persons, while the intra-country differences in treatment coverage were driven by the number of available direct-acting antiviral (DAA) courses. Conclusions: Over 98% of PLHIV in care in both CARE sites in Ukraine were receiving ART, and the target of 90% virally suppressed was achieved in persons >6 months on ART. Only one of six HIV/HCV study sites tested over 50% anti-HCV-positive PLHIV for HCV-RNA and treated over 25% of eligible persons. While free HCV-RNA testing and DAA treatment are paramount to achieving HCV elimination targets, they remained a challenge in Ukraine in 2019–2020. The extent of the HIV and HCV care disruption during the war will be further assessed in the CARE cohort and compared with the pre-war findings.
KW - cascade of care
KW - Eastern Europe
KW - hepatitis C
KW - HIV
KW - HIV/HCV
KW - Ukraine
U2 - 10.1002/jia2.26166
DO - 10.1002/jia2.26166
M3 - Journal article
C2 - 37705358
AN - SCOPUS:85171480616
VL - 26
JO - International AIDS Society. Journal
JF - International AIDS Society. Journal
SN - 1758-2652
IS - 9
M1 - e26166
ER -
ID: 396645852