engleski

From HIV diagnosis to treatment in Croatia in the COVID-19 year (2020)

Objectives: We describe where the HIV diagnosis was made, linkage to care, and the time from HIV diagnosis to antiretroviral treatment (ART) initiation in Croatia from 2017 to 2020. 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 HIV care from January 2017 to December 2020 and have previously not been in care elsewhere were extracted from the electronic database. We compared COVID-19 year (2020) to the previous three years (2017-2019). Results: Overall, 339 patients entered care from 2017 to 2020. The total number of HIV patients who entered care was the lowest in 2020 (Table). The first HIV positive test in 2020 was done in a voluntary testing and counseling center (VCT) in almost third cases (32.2% ; 19/59), followed by hospitals (25.4% ; 15/59), UHID (20.3% ; 12/59), community-based centers (5.1% ; 3/59), self-tests (3.4% ; 2/59) and other places (13.6% ; 8/59). In 2017-2020 most first HIV positive tests were done at hospitals (24.6% ; 69/280), followed by VCT (23.9% ; 67/280), UHID (22.9% ; 64/280), community- based centers (16.4% ; 46/280), other places (8.2% ; 23/280), unknown places (3.6% ; 10/280) and one self-test (0.4%) in 2019. Median CD4+ cell count at entry into care ranged from 254.5/mm3 (in 2017) to 335.0/mm3 (in 2019). Linkage to care within 7 days, 14 days and one month were somewhat lower in 2020 year (Table). ART was initiated earlier according to the first clinical visit in 2020 in comparison to 2017-2019: within 24 hours in 83.1% (49/59) vs. 74.3% (208/280) patients and within one week in 92.0% (54/59) vs. 85.7% (240/280) patients. Conclusions: The lower number of patients who entered HIV care in 2020 than previous years could reflect a trend towards ending the HIV epidemic in Croatia but could also present a negative impact of COVID-19 on HIV testing services and access to care.

HIV ; diagnosis ; treatment ; Croatia ; COVID-19

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