Comparative Study

. 2015 Oct;16(9):544-52.

doi: 10.1111/hiv.12256. Epub 2015 May 11.

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

M Mansfeld¹, A Skrahina², L Shepherd³, A Schultze³, A M Panteleev^{4

5}, R F Miller⁶, J M Miro⁷, I Zeltina⁸, S Tetradov^{9

10}, H Furrer¹¹, O Kirk¹, A Grzeszczuk¹², N Bolokadze¹³, A Matteelli¹⁴, F A Post¹⁵, J D Lundgren¹, A Mocroft³, Amw Efsen¹, D N Podlekareva¹; TB:HIV study group in EuroCoord

Collaborators, Affiliations

Collaborators

TB:HIV study group in EuroCoord:
M H Losso, J J Toibaro, D Palmero, B J Bartoletti, E Warley, M Michans, H Laplume, D David, C Marson, F P Scapelatto, D Dalessandro, S Lupo, G Costilla Campero, M Herbst, C Remondegui, C Elias, I Karpov, A Vassilenko, E Skrahina, A Skrahin, A Zalutskya, O Kondratenko, V Mitsura, V Bondarenko, O Suetnov, D Paduto, S Dewit, M C Payen, C Noscoi, K Kabeya, M Wolff, C Cortes, N Obel, G Kronborg, O Kirk, V Iljna, T Kummik, M Bryand, F Dabis, N Bolokadze, N Lanchava, N Bablishvili, L Goginashvili, L Mikiashvili, K Mshvidobadze, E Girardi, A Apostoli, S Barzoni, G Lapadula, M Purgatorio, S Carbonara, B Rozentale, I Zeltina, I Janushkevich, S Caplinskas, Z Kancauskienne, I Caplinskienne, B Crabtree, A Pina, J S Madero, J Mosqueda, J A Villanueva, A Grzeszczuk, M Bura, A Garlicki, M Inglot, B Knysz, J Kozlowska, J Loster, E Mularska, R Podlasin, D Duiculescu, S Tetradov, A Rakhmanova, A Yakovlev, A Panteleev, A Turkalova, Y Vlasova, T Trotimora, E Borodulina, L Chumanova, Y Mashkova, J M Miro, J A Caylá, A Moreno, J P Millet, A Orcau, L Fina, L del Baño, L L Roldán, A Romero, J A Martínez, C Manzardo, J González, G Tudo, H Knobel, F Sanchez, M Salvadó, A Curran, M T Tórtola, D Pozamczer, M Saumoy, F Alcaide, X Martínez-Lacasa, E Cuchí, M A Sambeat, V Pomar, P Coll, P Miralles, S Moreno, J A Iribarren, M Ibarguren, T Aldamiz, H Furrer, M Rickenbach, M Sagette, R F Miller, A Chapman, D Dockrell, E Wilkins, G Cooke, J Ainsworth, D Macallen, N Vora, S Mullaney, S Kegg, G Kyselyova, M Bruyand, J Caylá, D Duiculesku, H Furrer, E Girardi, M H Losso, J D Lundgren, R F Miller, J M Miro, N Obel, A Panteleev, J J Toibaro, L Shepherd, A Schultze, A Mocroft, A M Werlinrud Efsen, M Mansfeld, B Aagaard, B R Nielsen, A H Fisher, R S Brandt, D Raben, D Podlekareva, O Kirk

Affiliations

¹ CHIP (Centre for Health and Infectious Disease Research), Department of Infectious Diseases, Section 2100, Rigshospitalet - University of Copenhagen, Copenhagen, Denmark.
² Research Institute of Pulmonology and Pulmonary Tuberculosis, Minsk, Belarus.
³ Department of Infection and Population Health, University College London Medical School, London, UK.
⁴ TB Hospital #2, St Petersburg, Russia.
⁵ St Petersburg AIDS Centre, St Petersburg, Russia.
⁶ Centre for Sexual Health & HIV Research, Mortimer Market Centre, University College London, London, UK.
⁷ Infectious Diseases Service, Hospital Clinic, University of Barcelona, Barcelona, Spain.
⁸ Infectology Centre of Latvia, Riga, Latvia.
⁹ 'Dr Victor Babes' Hospital of Tropical and Infectious Diseases, Bucharest, Romania.
¹⁰ 'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania.
¹¹ Department of Infectious Diseases, Bern University Hospital and University of Bern, Bern, Switzerland.
¹² Department of Infectious Diseases and Hepatology, Medical University of Bialystok, Bialystok, Poland.
¹³ Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia.
¹⁴ Institute of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy.
¹⁵ King's College Hospital NHS Foundation Trust, London, UK.

PMID: 25959854
PMCID: PMC5111860
DOI: 10.1111/hiv.12256

Comparative Study

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

M Mansfeld et al. HIV Med. 2015 Oct.

. 2015 Oct;16(9):544-52.

doi: 10.1111/hiv.12256. Epub 2015 May 11.

Authors

Collaborators

TB:HIV study group in EuroCoord:
M H Losso, J J Toibaro, D Palmero, B J Bartoletti, E Warley, M Michans, H Laplume, D David, C Marson, F P Scapelatto, D Dalessandro, S Lupo, G Costilla Campero, M Herbst, C Remondegui, C Elias, I Karpov, A Vassilenko, E Skrahina, A Skrahin, A Zalutskya, O Kondratenko, V Mitsura, V Bondarenko, O Suetnov, D Paduto, S Dewit, M C Payen, C Noscoi, K Kabeya, M Wolff, C Cortes, N Obel, G Kronborg, O Kirk, V Iljna, T Kummik, M Bryand, F Dabis, N Bolokadze, N Lanchava, N Bablishvili, L Goginashvili, L Mikiashvili, K Mshvidobadze, E Girardi, A Apostoli, S Barzoni, G Lapadula, M Purgatorio, S Carbonara, B Rozentale, I Zeltina, I Janushkevich, S Caplinskas, Z Kancauskienne, I Caplinskienne, B Crabtree, A Pina, J S Madero, J Mosqueda, J A Villanueva, A Grzeszczuk, M Bura, A Garlicki, M Inglot, B Knysz, J Kozlowska, J Loster, E Mularska, R Podlasin, D Duiculescu, S Tetradov, A Rakhmanova, A Yakovlev, A Panteleev, A Turkalova, Y Vlasova, T Trotimora, E Borodulina, L Chumanova, Y Mashkova, J M Miro, J A Caylá, A Moreno, J P Millet, A Orcau, L Fina, L del Baño, L L Roldán, A Romero, J A Martínez, C Manzardo, J González, G Tudo, H Knobel, F Sanchez, M Salvadó, A Curran, M T Tórtola, D Pozamczer, M Saumoy, F Alcaide, X Martínez-Lacasa, E Cuchí, M A Sambeat, V Pomar, P Coll, P Miralles, S Moreno, J A Iribarren, M Ibarguren, T Aldamiz, H Furrer, M Rickenbach, M Sagette, R F Miller, A Chapman, D Dockrell, E Wilkins, G Cooke, J Ainsworth, D Macallen, N Vora, S Mullaney, S Kegg, G Kyselyova, M Bruyand, J Caylá, D Duiculesku, H Furrer, E Girardi, M H Losso, J D Lundgren, R F Miller, J M Miro, N Obel, A Panteleev, J J Toibaro, L Shepherd, A Schultze, A Mocroft, A M Werlinrud Efsen, M Mansfeld, B Aagaard, B R Nielsen, A H Fisher, R S Brandt, D Raben, D Podlekareva, O Kirk

Affiliations

¹ CHIP (Centre for Health and Infectious Disease Research), Department of Infectious Diseases, Section 2100, Rigshospitalet - University of Copenhagen, Copenhagen, Denmark.
² Research Institute of Pulmonology and Pulmonary Tuberculosis, Minsk, Belarus.
³ Department of Infection and Population Health, University College London Medical School, London, UK.
⁴ TB Hospital #2, St Petersburg, Russia.
⁵ St Petersburg AIDS Centre, St Petersburg, Russia.
⁶ Centre for Sexual Health & HIV Research, Mortimer Market Centre, University College London, London, UK.
⁷ Infectious Diseases Service, Hospital Clinic, University of Barcelona, Barcelona, Spain.
⁸ Infectology Centre of Latvia, Riga, Latvia.
⁹ 'Dr Victor Babes' Hospital of Tropical and Infectious Diseases, Bucharest, Romania.
¹⁰ 'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania.
¹¹ Department of Infectious Diseases, Bern University Hospital and University of Bern, Bern, Switzerland.
¹² Department of Infectious Diseases and Hepatology, Medical University of Bialystok, Bialystok, Poland.
¹³ Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia.
¹⁴ Institute of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy.
¹⁵ King's College Hospital NHS Foundation Trust, London, UK.

PMID: 25959854
PMCID: PMC5111860
DOI: 10.1111/hiv.12256

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.

Keywords: Europe; HIV; delivery of health care; integrated; tuberculosis.

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Conflict of interest statement

None of the authors has a conflict of interest to declare.

Figures

**Fig. 1**
Integration of care for patients with HIV/tuberculosis (TB) in Eastern (EE) and Western Europe (WE). *P < 0.05. OST, opioid substitution therapy.

**Fig. 2**
Availability of (a) second-line and (b) third-line anti-TB drugs in Eastern (EE) and Western Europe (WE). *P < 0.05. PAS, P-aminosalicylic acid.

See this image and copyright information in PMC

References

1. UNAIDS. UNAIDS Report on the Global AIDS Epidemic. Geneva: UNAIDS; 2013. [accessed 02 December 2013]. Available at http://www.unaids.org/en/media/unaids/contentassets/documents/epidemiolo....
1. World Health Organization. Global Tuberculosis Report. Geneva: World Health Organization; 2014. [accessed 02 December 2014]. Available at http://www.who.int/tb/publications/global_report/gtbr14_main_text.pdf?ua=1.
1. Podlekareva DN, Mocroft A, Post FA, et al. HIV/TB Study Writing Group. Mortality from HIV and TB coinfections is higher in Eastern Europe than in Western Europe and Argentina. AIDS. 2009;18:2485–2495. - PubMed
1. Dehovitz J, Uuskula A, El-Bassel N. The HIV epidemic in Eastern Europe and Central Asia. Curr HIV/AIDS Rep. 2014;11:168–176. - PubMed
1. Dara M, Dadu A, Kremer K, Zaleskis R, Kluge HH. Epidemiology of tuberculosis in WHO European Region and public health response. Eur Spine J. 2013;4:549–555. - PMC - PubMed

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

Collaborators

Affiliations

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

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Substances

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical