학술논문
Clinical Perspective on Human Immunodeficiency Virus Care of Ukrainian War Refugees in Poland.
Document Type
Article
Author
Parczewski, Miłosz; Jabłonowska, Elżbieta; Wójcik-Cichy, Kamila; Zhyvytsia, Dmytro; Witak-Jędra, Magdalena; Leszczyszyn-Pynka, Magdalena; Aksak-Wąs, Bogusz; Siwak, Ewa; Cielniak, Iwona; Olczak, Anita; Szymczak, Aleksandra; Szetela, Bartosz; Bociąga-Jasik, Monika; Kalinowska-Nowak, Anna; Mularska, Elżbieta; Witor, Adam; Jakubowski, Paweł; Hlebowicz, Maria; Rozpłochowski, Błażej; Łojewski, Władysław
Source
Subject
*EVALUATION of medical care
*DIAGNOSIS of HIV infections
*HEPATITIS C diagnosis
*AIDS diagnosis
*HIV infections
*ANTI-HIV agents
*VIRAL antigens
*HEPATITIS B
*DRUG efficacy
*HIV integrase inhibitors
*SEQUENCE analysis
*GENETIC mutation
*HEALTH services accessibility
*WAR
*REVERSE transcriptase inhibitors
*VIRAL load
*UKRAINIANS
*HIV protease inhibitors
*SYMPTOMS
*REFUGEES
*MIXED infections
*CD4 lymphocyte count
*MULTIDRUG resistance
*DESCRIPTIVE statistics
*RESEARCH funding
*DRUG resistance in microorganisms
*VIRAL antibodies
*AIDS
*HIV
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
Language
ISSN
1058-4838
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. [ABSTRACT FROM AUTHOR]