engleski

Viral hepatitis in HIV-positive patients - testing, prophylaxis and treatment in Central and Eastern Europe

Objectives: Because of shared routes of transmission hepatitis C (HCV) and hepatitis B (HBV) are the most common co-infections in people living with HIV (PLWH). All PLWH should be vaccinated against HBV and hepatitis A virus (HAV) and treated for HBV and HCV due to increased risk of developing endstage liver disease. We aimed to describe testing, prophylaxis and treatment of viral hepatitis in PLWH in Central and Eastern Europe. Method: Data was collected from 18 countries of Euroguidelines in Central and Eastern Europe Network Group (ECEE): Serbia, Turkey, Bosnia and Herzegovina, Romania, Bulgaria, Croatia, Estonia, Ukraine, Hungary, Greece, Albania, Armenia, Czech Republic, Georgia, Belarus, Slovakia, Lithuania, Poland, four countries had information from two centers. Results: In total 21 of 22 (95%) centers in ECEE screen all PLWH for HCV antibodies and for HBsAg. In 20 centers (91%) HCV testing is free of charge either covered by governmental programs (five centers (23%)) or by health insurance (15 centers (68%)), in two centers (9%) PLWH have to pay. All centers have access to DAAs but only six centers (27%) have no limitations for treatment access. HbsAg testing is covered by governmental programs in four centers (18%), by health insurance in 15 centers (68%), in three centers (14%) HBsAg screening is available as paid service. 13 centers (59%) vaccinate all PLWH against HBV, it is free of charge in 11 centers (50%). In HIV/HBV coinfected patients 20 centers (91%) use tenofovir-based regimen. Only 12 centers of 22 (55%) screen for HAV IgG, and three centers (14%) vaccinate all PLWH against HAV, vaccination is free of charge in six centers (29%). Conclusion: Testing for viral hepatitis in PLWH in ECEE is sufficiently good, however, vaccination against HBV especially against HAV has room for improvement, also HCV treatment access needs rectification in entire ECEE.

Viral hepatitis ; HIV-positive patients ; testing ; prophylaxis ; treatment ; Central and Eastern Europe

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