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Background/objectives: Inadequate HIV care for hard-to-reach populations may result in failing the UNAIDS 90–90–90 goal. Therefore, we aimed to review the HIV continuum of care and hard-to-reach populations for each step of the continuum in Central, Eastern and South Eastern Europe. Methods: Euro-guidelines in Central and Eastern Europe (ECEE) Network Group were created in February 2016. The aim of the network was to review the standards of HIV care in the countries of the region. Information about each stage of HIV continuum of care and hard-to-reach populations for each stage was collected through on-line surveys. Respondents were ECEE members chosen based on their expertise and involvement in national HIV care. Data sources (year 2016) used by respondents included HIV Clinics electronic databases, Institutes of Public Health, Centres for AIDS Prevention, and HIV Programme Reviews. Results: The percentage of people living with HIV (PLHIV) linked to HIV care after HIV diagnosis was ranged between 80% and 96% in Central Europe, 51% and 92% in Eastern Europe and 80% and 100% in South-Eastern Europe. The percentage of PLHIV who are on ART was ranged from 80% to 93% in Central Europe, 18% to 92% in Eastern Europe and 80% to 100% in South-Eastern Europe. The percentage of people virologically suppressed while on ART was reported as 70–95%, 12–95% and 62–97% in Central, Eastern, and South Eastern Europe, respectively. All three regions reported people who inject drugs (PWID) as hard-to-reach population across all HIV continuum stages. Migrants were the second most reported hard-to-reach population. The proportion of late presenters among newly diagnosed ranged between 20% and 55%, 40% and 55% and 48% and 60% in Central, Eastern and South Eastern Europe, respectively. Four countries reported ARVs' delivery delays resulting in treatment interruptions in 2016: two (25%) in South-Eastern, one (20%) in Central and 1 (16.7%) in Eastern Europe. Conclusion: Irrespective of the diversity in national HIV epidemics, countries from all three regions reported PWIDs as hard-to-reach population across all HIV continuum stages. Some countries are close to the UNAIDS 2020 goals, others need to strive for progress. However, differences in data sources and variations in definitions limit the utility of continuum of care as a comparative tool. [ABSTRACT FROM AUTHOR]

Objectives: Pre‐exposure prophylaxis (PrEP) for HIV infection has been introduced in only a few European countries. We investigated the potential to provide PrEP in the Central and Eastern European region, and in neighbouring countries. Methods: The Euroguidelines in Central and Eastern Europe (ECEE) Network Group was formed in February 2016 to review standards of care for HIV infection in the region. Information related to PrEP was collected through on‐line surveys. Respondents were recruited by ECEE members based on their involvement in HIV care. Results: Seventy‐six respondents from 23 countries participated in the survey. Twenty‐six (34.2%) respondents reported that PrEP [tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC)] was registered by the drug registration authority in their country. Fifty‐three (70.7%) respondents reported being aware of ‘informal’ PrEP use in their country. If they had access to PrEP, 56 (74.7%) would advise its use in their practice. Forty‐five (59.2%) respondents had concerns regarding PrEP use, and 10 (13.3%) expressed the need for more training. Most of the respondents (88.2%) would provide PrEP to people with high‐risk behaviours. Conclusions: PrEP is already used informally in some countries in the region. Physicians are keen to use PrEP if and when it is accessible. Obstacles towards implementing PrEP in those countries were mostly related to lack of national guidelines, drug registration and governmental strategy. [ABSTRACT FROM AUTHOR]

Regional differences across Europe in triple class failure (TCF; the failure of each of the three separate main classes of antiretrovirals (ARVs) with a viral load >1000 HIV-1 RNA copies/mL for >4 months) have not been described. A total of 1956 patients started combination ARV therapy after 1 January 1999, of whom 123 patients developed TCF [6.3%; incidence 16.7 per 1000 person-years of follow-up; 95% confidence interval (CI) 13.7–19.6]. After adjustment, patients from Eastern Europe had a significantly increased incidence of TCF compared with patients from Southern Europe/Argentina (3.05; 95% CI 1.36–6.82; P=0.0067) while patients taking either a boosted protease inhibitor regimen (0.33; 95% CI 0.15–0.74; P=0.0072) or a nonnucleotide reverse transcriptase inhibitor (NNRTI)-based regimen (0.59; 95% CI 0.37–0.94; P=0.026) had a reduced incidence of TCF. [ABSTRACT FROM AUTHOR]

Objectives: Survey was conducted to assess state of viral hepatitis care in Central and Eastern Europe (CEE).Methods: Representatives of 16 CEE countries completed on-line survey in April-May 2017 that collected information on basic epidemiology and availability of key services for HCV and HBV infections. Sources of information provided ranged from national surveillance data to expert opinion.Results: The burden of viral hepatitis varied between countries, ranging from 6,500 to 2 million for HCV and from 10,000 to 3 million for HBV. Access to routine HCV RNA testing and genotyping was reported by 11 and 9 countries, respectively. HCV resistance testing was available in 7 countries. Direct acting antivirals (DAAs) were available in 13 countries, most frequently Sofosbuvir and Ledipasvir/Sofosbuvir (12 countries apiece) and Ombitasvir/Paritaprevir/Dasabuvir (9 countries). HBV DNA testing and HBV genotyping were routinely available in 10 and 7 countries, respectively. Eleven countries reported available treatment with Tenofovir.Conclusions: There are gaps in viral hepatitis care in CEE. Despite the availability of registered modern drugs for HCV and HBV, the access to treatment is limited. Ensuring quality health care is essential to reduce the epidemic and achieve the WHO's goal of eliminating viral hepatitis as a major public health challenge. [ABSTRACT FROM AUTHOR]