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. 2023 May 24;76(10):1708-1715.
doi: 10.1093/cid/ciad116.

Clinical Perspective on Human Immunodeficiency Virus Care of Ukrainian War Refugees in Poland

Miłosz Parczewski  1 , Elżbieta Jabłonowska  2 , Kamila Wójcik-Cichy  2 , Dmytro Zhyvytsia  3 , Magdalena Witak-Jędra  3 , Magdalena Leszczyszyn-Pynka  3 , Bogusz Aksak-Wąs  1 , Ewa Siwak  4 , Iwona Cielniak  4 , Anita Olczak  5 , Aleksandra Szymczak  6 , Bartosz Szetela  6 , Monika Bociąga-Jasik  7 , Anna Kalinowska-Nowak  7 , Elżbieta Mularska  8 , Adam Witor  8 , Paweł Jakubowski  9 , Maria Hlebowicz  10 , Błażej Rozpłochowski  11 , Władysław Łojewski  12 , Kaja Scheibe  1 , Karol Serwin  1
Affiliations

Clinical Perspective on Human Immunodeficiency Virus Care of Ukrainian War Refugees in Poland

Miłosz Parczewski et al. Clin Infect Dis. .

Erratum in

Abstract

Background: The Russian invasion of Ukraine forced migration for safety, protection, and assistance. Poland is the primary sheltering country for Ukrainian refugees, providing support including medical care, which resulted in the rapid ∼15% increase in the number of followed-up people with human immunodeficiency virus (HIV) (PWH) in the country. Here, we present the national experience on HIV care provided for refugees from Ukraine.

Methods: Clinical, antiretroviral, immunological, and virologic data from 955 Ukrainian PWH entering care in Poland since February 2022 were analyzed. The dataset included both antiretroviral-treated (n = 851) and newly diagnosed (n = 104) patients. In 76 cases, protease/reverse transcriptase/integrase sequencing was performed to identify drug resistance and subtype.

Results: Most (70.05%) of the patients were female, with a predominance of heterosexual (70.3%) transmissions. Anti-hepatitis C antibody and hepatitis B antigen were present in 28.7% and 2.9% of the patients, respectively. A history of tuberculosis was reported in 10.1% of cases. Among previously treated patients, the viral suppression rate was 89.6%; 77.3% of newly HIV diagnosed cases were diagnosed late (with lymphocyte CD4 count <350 cells/μL or AIDS). The A6 variant was observed in 89.0% of sequences. Transmitted mutations in the reverse transcriptase were found in 15.4% treatment-naive cases. Two patients with treatment failure exhibited multiclass drug resistance.

Conclusions: Migration from Ukraine influences the characteristics of HIV epidemics in Europe, with an increase in the proportion of women and hepatitis C coinfected patients. Antiretroviral treatment efficacy among previously treated refugees was high, with new HIV cases frequently diagnosed late. The A6 subtype was the most common variant.

Keywords: HIV migrant care; HIV subtypes; antiretroviral treatment efficacy; resistance.

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Conflict of interest statement

Potential conflicts of interest. B. S. reports consulting fees to the author from ViiV and Merck, to his institution from AbbVie, and to the author and his institution from Gilead and Janssen; payment or honoraria for lectures, presentations, speaker’s bureaus, manuscript writing, or educational events from ViiV, Gilead, AbbVie, Mylan, and Merck; payment for expert testimony from ViiV; support for attending meetings and/or travel from Gilead, Janssen, and AbbVie; participation on a Data Safety Monitoring Board or Advisory Board for ViiV; and receipt of equipment, materials, drugs, medical writing, gifts or other services to his institution from AbbVie. M. P. reports grants or contracts paid to the author from Regional Hospital I, Szczecin, Poland; payment or honoraria to the author for lectures, presentations, speaker’s bureaus, manuscript writing, or educational events from Gilead, Janssen, AbbVie, Roche, ViiV/GlaxoSmithKline (GSK), and Merck Sharp & Dohme (MSD); unpaid roles as President, Polish AIDS Society, and as Vice-President, European AIDS Clinical Society (EACS). I. C. reports full employment in the Hospital for Infectious Diseases in Warsawgi; payment or honoraria for lectures, presentations, speaker’s bureaus, manuscript writing, or educational events from GSK or Gilead; and participation on a Data Safety Monitoring Board or Advisory Board from Gilead. E. J. reports payment or honoraria for lectures, presentations, speaker’s bureaus, manuscript writing, or educational events from GSK, Janssen, and Gilead; support for attending meetings and/or travel from GSK and Gilead; and participation on a Data Safety Monitoring Board or Advisory Board from GSK and Gilead, all unrelated to this article. D. Z. reports grants or contracts unrelated to this work from Samodzielny Publiczny Wojewódzki Szpital Zespolony w Szczecinie. B. A.-W. reports payment or honoraria for lectures from Gilead and GSK and conference fees from Gilead. M. B. J. reports participation on an Advisory Board for GSK, Gilead Sciences Poland, and Janssen-Cilag Poland; a role as a member of the Board of Polish AIDS Society; and other financial or nonfinancial interests as speaker during the meeting organized by Gilead Sciences Poland, MSD Poland, Janssen-Cilag Poland, and GSK. P. J. reports consulting fees and an Advisory Board honorarium paid directly to the author from MSD Polska sp. Zo.o., Janssen Cilag Polska sp. Z o.o., and GSK Commercial sp. Z o.o.; lectures and an honorarium paid directly to the author from Gilead Sciences Poland sp. Z o.o., Janssen Cilag Polska sp. Z o.o., and GSK Commercial sp. Z o.o.; conference travel, accommodations, and fees paid directly to conference organizers from Gilead Sciences Poland sp. Z o.o.; consultation fees paid directly to the author by JMJ sp. Z o.o., Master Conference Group, Punkt Zdrowia Hlebowicz Jakubowski Lekarze sp. p., Neutrum Lekarze M. Hlebowicz i Partnerzy sp. p.; and a consultation honorarium paid directly to the author from Iqvia RDS Poland sp. Z o.o. M. H. reports lectures and an honorarium paid directly to the author from Gilead Sciences Poland sp. z o.o. and GSK Commercial sp. Z o.o.; conference travel, accommodations, and fees paid directly to conference organizers from Gilead Sciences Poland sp. Z o.o.; and consultation fees paid directly to the author from Punkt Zdrowia Hlebowicz Jakubowski Lekarze sp. p. and Neutrum Lekarze M. Hlebowicz i Partnerzy sp. p. A. O. reports payments made to the author for lectures, presentations, speaker’s bureaus, manuscript writing, or educational events from GSK, MSD, AbbVie, Janssen, and Gilead; support for attending meetings and/or travel made to the author from Gilead, AbbVie, Janssen, and MSD; participation on a Data Safety Monitoring Board or Advisory Board for Janssen; unpaid leadership or fiduciary roles with Polish Scientific AIDS Society and Polish Association of Epidemiologists and Infectiologists. A. K.-N. reports fees and travel to the conference HIV Drug Therapy Glasgow 2022 from Gilead Sciences Poland and other financial or nonfinancial interests as speaker during the meeting organized by Gilead Sciences Poland, Janssen-Cilag Poland, and GSK. M. W.-J. reports payment to the author for lectures, presentations, speaker’s bureaus, manuscript writing, or educational events from Gilead, GSK, and Medical Tribune, and an unpaid role as Secretary of the Polish AIDS Scientific Society. B. R. reports grants or contracts from J. Struś Multispecialist City Hospital, Poznan and payment or honoraria and support for meetings and/or travel from Gilead Sciences Poland, GSK ViiV, MSD Poland, AbbVie, and Janssen Cilag Poland. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

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