Epidemiological characteristics and access to end-stage liver disease care for HIV-positive patients with HCV and/or HBV coinfections in Central/Eastern European and neighboring countries – data from the ECEE network
Epidemiological characteristics and access to end-stage liver disease care for HIV-positive patients with HCV and/or HBV coinfections in Central/Eastern European and neighboring countries – data from the ECEE network
复制标题
中欧/东欧及邻国 HCV 和/或 HBV 合并感染的 HIV 阳性患者的流行病学特征和获得终末期肝病护理的机会 – 数据来自 ECEE 网络
DOI：
10.32394/pe.73.07
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发表时间：
2019
影响因子：
--
通讯作者：
A. Horban
中科院分区：
文献类型：
--
作者：
A. Skrzat;B. Matłosz;D. Otelea;A. Harxhi;A. Vassilenko;N. Bolokadze;K. Rüütel;A. Papadopoulos;M. Mărdărescu;M. Youle;J. D. Kowalska;A. Horban
目标
目前迫切需要协调整个欧洲艾滋病毒阳性患者的肝炎护理标准。中欧和东欧的艾滋病毒流行往往是由注射吸毒引起的，因此预计该地区丙型肝炎病毒和乙型肝炎病毒的混合感染率较高。我们调查了 ECEE 网络小组所代表的国家中 HIV/HCV/HBV 合并感染的终末期肝病的流行病学患病率和治疗可用性。
方法
中欧和东欧欧洲指南 (ECEE) 网络小组于 2016 年 2 月启动，旨在比较该地区艾滋病毒感染的护理标准。通过在线调查收集了有关 HIV/HCV/HBV 合并感染以及 HIV 阳性患者接受终末期肝病治疗的可能性的信息。受访者是来自该地区 16 个国家的 ECEE 成员。关于合并感染流行率的信息来自世界卫生组织、国家艾滋病毒规划、国际期刊上发表的文章、单一临床报告以及十个参与国家（62.5%）的个人信息。
结果
HIV/HCV合并感染率为3%至99%。报告的 HIV/HBV 合并感染百分比范围为 2.3% 至 40%。 HIV/HCV/HBV 混合感染率为 0% 至 9%。关于终末期肝病的治疗，只有三个国家（19%）的 HIV 阳性患者可以选择肝移植。
结论
我们的研究结果显示，对于绝大多数中欧和东欧国家的艾滋病毒阳性患者来说，终末期肝病的治疗方案数量有限。该地区的流行病学监测存在差距。中东欧及周边国家的合并感染患者数量似乎存在较大差异，但信息来源并不统一。
OBJECTIVES
There is currently an urgent need to harmonize hepatitis standards of care for HIV-positive patients across Europe. The HIV epidemic in Central and Eastern Europe has often been driven by injecting drug use, therefore a higher rate of co-infection with HCV and HBV is expected in this region. We have investigated the epidemiological prevalence and treatment availability for end-stage liver disease in HIV/HCV/HBV coinfections in countries represented in the ECEE Network Group.
METHODS
The Euroguidelines in Central and Eastern Europe (ECEE) Network Group was initiated in February 2016 to compare standards of care regarding HIV infection in the region. Information about HIV/HCV/HBV co-infections and the availability for end-stage liver disease treatment for HIV-positive patients were collected through on-line surveys. The respondents were ECEE members from 16 countries of the region. The information on co-infection prevalence was sourced from WHO, national HIV programmes, articles published in international journals, single clinic reports, and personal information in ten of the participating countries (62.5%).
RESULTS
The HIV/HCV co-infection rate was from 3% to 99%. The range of reported of HIV/HBV coinfection percentages was 2.3% to 40%. HIV/HCV/HBV co-infection ranged from 0% to 9%. Regarding treatment for end-stage liver disease, liver transplantation was an available option for HIV-positive patients in only three countries (19%).
CONCLUSION
Our findings revealed only a limited number of treatment options for the end-stage liver disease in HIV-positive patients for the vast majority of Central and Eastern European countries. There are gaps in epidemiological surveillance in this region. It appears there are many differences in the number of co-infected patients among Central and Eastern European and neighboring countries, but there is no unification of information sources.