engleski

From HIV diagnosis to antiretroviral therapy initiation in Croatia from 2013 to 2018

Purpose: We describe where the HIV diagnosis was made, linkage to care and the time from HIV diagnosis to antiretroviral therapy (ART) initiation in Croatia, 2013 to 2018. Methods: Croatia has a centralized system of care and all HIV patients are treated at the University Hospital for Infectious Diseases (UHID) in Zagreb. Data on persons entering care were extracted from the electronic database at UHID. Included were the persons that were nationals or residents of Croatia that have previously not been in care elsewhere. Results: Overall 587 patients entered care from 2013 to 2018. The first HIVpositive test was done at: hospitals (other than UHID) in 150 (25.6%) persons, voluntary counselling and testing settings in 147 (25.0%), UHID in 103 (17.5%), community-based settings in 85 (14.5%), other places in 62 (10.6%) and unknown sites in 40 (6.8%) persons. For the period 2014–2018, linkage to care among those who entered care, was within 7 days of the first HIVpositive test in 53%, within 14 days in 78% and within one month in 91% persons. The median CD4+ cell count at entry into care ranged from 255/lL in 2017 to 341/lL in 2018. It was very low when HIV was diagnosed in hospital settings (median, 84/lL) and highest when HIV was diagnosed at community-based settings (median, 413/lL). In 2017 and 2018 ART was initiated within 24 hours from the first clinical visit in 78% and 71% persons respectively, whereas in 2014–2016 it was initiated in 36–62% persons. Conclusion: Community-based HIV testing contributed to earlier HIV diagnosis. Linkage to care was very good and rapid ART initiation is currently a common practice in Croatia. Expanding community-based HIVtesting accompanied by prompt linkage and early ART might contribute to the decrease of new HIV-infections in Croatia.

HIV ; antiretroviral therapy ; Croatia

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