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1. Management of MDR-TB in HIV co-infected patients in Eastern Europe: Results from the TB:HIV study

Author

Karpov, I., Vassilenko, A., Skrahina, A., Klimuk, D., Skrahin, A., Kondratenko, O., Zalutskaya, A., Bondarenko, V., Mitsura, V., Kozorez, E., Tumash, O., Suetnov, O., Paduto, D., Iljina, V., Kummik, T., Bolokadze, N., Mshvidobadze, K., Lanchava, N., Goginashvili, L., Mikiashvili, L., Bablishvili, N., Rozentale, B., Zeltina, I., Janushkevich, I., Caplinskiene, I., Caplinskas, S., Kancauskiene, Z., Podlasin, R., Wiercinska-Drapalo, A., Thompson, M., Kozlowska, J., Grezesczuk, A., Bura, M., Knysz, B., Inglot, M., Garlicki, A., Loster, J., Tetradov, S., Duiculescu, D., Rakhmanova, A., Panteleeva, O., Yakovlev, A., Kozlov, A., Tyukalova, A., Vlasova, Y., Panteleev, A., Trofimov, T., Kyselyova, G., Andersen, A.B., Thorsteinsson, K., Payen, M.C., Kabeya, K., Necsoi, C., Dabis, F., Bruyand, M., Morlat, P., Dupont, A., Gerard, Y., Bonnal, F., Ceccaldi, J., De Witte, S., Monlun, E., Lataste, P., Chossat, I., Miller, R., Vora, N., Cooke, G., Mullaney, S., Wilkins, E., George, V., Collini, P., Dockrell, D., Post, F., Campbell, L., Brum, R., Mabonga, E., Saigal, P., Kegg, S., Ainsworth, J., Waters, A., Dhar, J., Mashonganyika, L., Girardi, E., Rianda, A., Galati, V., Pinnetti, C., Tommasi, C., Lapadula, G., Di Biagio, A., Parisini, A., Carbonara, S., Angarano, G., Purgatorio, M., Matteelli, A., Apostoli, A., Toibaro, J., Macias, L. Moreno, Warley, E., Tavella, S., Garcia Messina, O., Gear, O., Laplume, H., Marson, C., Contarelia, J., Michaan, M., Scapellato, P., Alessandro, D.D., Bartoletti, B., Palmero, D., Elias, C., Cortes, C., Crabtree, B., Mosqueda Gomez, J.L., Villanueva, A., Gonzalez Hernandez, L.A., Efsen, A.M.W., Schultze, A., Miller, R.F., Podlekareva, D.N., Miro, J.M., Furrer, H., Losso, M.H., Caylà, J.A., Mocroft, A., Lundgren, J.D., Post, F.A., and Kirk, O.

Published
2018
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2. Healthcare delivery for HIV-positive people with tuberculosis in Europe

Author

Bentzon, A, Panteleev, A, Mitsura, V, Borodulina, E, Skrahina, A, Denisova, E, Tetradov, S, Podlasin, R, Riekstina, V, Kancauskiene, Z, Paduto, D, Mocroft, A, Trofimova, T, Miller, R, Post, F, Grezesczuk, A, Lundgren, J, Inglot, M, Podlekareva, D, Bolokadze, N, Kirk, O, Karpov, I, Vassilenko, A, Klimuk, D, Skrahin, A, Kondratenko, O, Zalutskaya, A, Bondarenko, V, Kozorez, E, Tumash, O, Suetnov, O, Iljina, V, Kummik, T, Mshvidobadze, K, Lanchava, N, Goginashvili, L, Mikiashvili, L, Bablishvili, N, Rozentale, B, Zeltina, I, Janushkevich, I, Caplinskiene, I, Caplinskas, S, Wiercinska-Drapalo, A, Thompson, M, Kozlowska, J, Bura, M, Knysz, B, Garlicki, A, Loster, J, Duiculescu, D, Rakhmanova, A, Panteleeva, O, Yakovlev, A, Kozlov, A, Tyukalova, A, Vlasova, Y, Trofimov, T, Kyselyova, G, Obel, N, Gerstoft, J, Kronborg, G, Payen, M, Kabeya, K, Necsoi, C, Dabis, F, Tsaranazy, A, Cazanave, C, Furrer, H, Sagette, M, Rickenbach, M, Elzi, L, Battegay, M, Sculier, D, Calmy, A, Cavassini, M, Bruno, A, Bernasconi, E, Hoffmann, M, Vernazza, P, Fehr, J, Weber, R, Vora, N, Cooke, G, Mullaney, S, Wilkins, E, George, V, Collini, P, Dockrell, D, Campbell, L, Brum, R, Mabonga, E, Saigal, P, Kegg, S, Ainsworth, J, Waters, A, Dhar, J, Ellis, K, Spallanzani, O, Girardi, E, Rianda, A, Galati, V, Pinnetti, C, Tommasi, C, San Gerardo, A, Lapadula, G, Di Biagio, A, Parisini, A, Carbonara, S, Angarano, G, Purgatorio, M, Matteelli, A, Apostoli, A, Miro, J, Manzardo, C, Ligero, C, Gonzalez, J, Martinez-Martinez, J, Sanchez, F, Knobel, H, Salvado, M, Lopez-Colomes, J, Martinez-Lacasa, X, Cuchi, E, Falco, V, Curran, A, Tortola, M, Ocana, I, Vidal, R, Sambeat, M, Pomar, V, Coll, P, Pozamczer, D, Saumoy, M, Alcaide, F, Cayla, J, Moreno, A, Millet, J, Orcau, A, Fina, L, Romero, A, Roldan, L, Iribarren, J, Ibarguren, M, Moreno, S, Gonzalez, A, Miralles, P, Aldamiz-Echevarria, T, Losso, M, Toibaro, J, Gambardella, L, Ramos Mejia, J, Moreno Macias, L, Warley, E, Tavella, S, Garcia Messina, O, Gear, O, Laplume, H, Marson, C, Contarelia, J, Michaan, M, Scapellato, P, Bartoletti, B, Palmero, D, Elias, C, Cortes, C, Crabtree, B, Mosqueda Gomez, J, Villanueva, J, Gonzalez Hernandez, L, Badial, F, Bentzon A. K., Panteleev A., Mitsura V., Borodulina E., Skrahina A., Denisova E., Tetradov S., Podlasin R., Riekstina V., Kancauskiene Z., Paduto D., Mocroft A., Trofimova T., Miller R., Post F., Grezesczuk A., Lundgren J. D., Inglot M., Podlekareva D., Bolokadze N., Kirk O., Karpov I., Vassilenko A., Klimuk D., Skrahin A., Kondratenko O., Zalutskaya A., Bondarenko V., Kozorez E., Tumash O., Suetnov O., Iljina V., Kummik T., Mshvidobadze K., Lanchava N., Goginashvili L., Mikiashvili L., Bablishvili N., Rozentale B., Zeltina I., Janushkevich I., Caplinskiene I., Caplinskas S., Wiercinska-Drapalo A., Thompson M., Kozlowska J., Bura M., Knysz B., Garlicki A., Loster J., Duiculescu D., Rakhmanova A., Panteleeva O., Yakovlev A., Kozlov A., Tyukalova A., Vlasova Y., Trofimov T., Kyselyova G., Obel N., Gerstoft J., Kronborg G., Payen M. C., Kabeya K., Necsoi C., Dabis F., Tsaranazy A., Cazanave C., Furrer H., Sagette M., Rickenbach M., Elzi L., Battegay M., Sculier D., Calmy A., Cavassini M., Bruno A., Bernasconi E., Hoffmann M., Vernazza P., Fehr J., Weber R., Vora N., Cooke G., Mullaney S., Wilkins E., George V., Collini P., Dockrell D., Campbell L., Brum R., Mabonga E., Saigal P., Kegg S., Ainsworth J., Waters A., Dhar J., Ellis K., Spallanzani O. L., Girardi E., Rianda A., Galati V., Pinnetti C., Tommasi C., San Gerardo A. O., Lapadula G., Di Biagio A., Parisini A., Carbonara S., Angarano G., Purgatorio M., Matteelli A., Apostoli A., Miro J. M., Manzardo C., Ligero C., Gonzalez J., Martinez-Martinez J. A., Sanchez F., Knobel H., Salvado M., Lopez-Colomes J. L., Martinez-Lacasa X., Cuchi E., Falco V., Curran A., Tortola M. T., Ocana I., Vidal R., Sambeat M. A., Pomar V., Coll P., Pozamczer D., Saumoy M., Alcaide F., Cayla J., Moreno A., Millet J. P., Orcau A., Fina L., Romero A., Roldan L. L., Iribarren J. A., Ibarguren M., Moreno S., Gonzalez A., Miralles P., Aldamiz-Echevarria T., Losso M., Toibaro J., Gambardella L., Ramos Mejia J. M., Moreno Macias L., Warley E., Tavella S., Garcia Messina O., Gear O., Laplume H., Marson C., Contarelia J., Michaan M., Scapellato P., Bartoletti B., Palmero D., Elias C., Cortes C., Crabtree B., Mosqueda Gomez J. L., Villanueva J. A., Gonzalez Hernandez L. A., Badial F., Bentzon, A, Panteleev, A, Mitsura, V, Borodulina, E, Skrahina, A, Denisova, E, Tetradov, S, Podlasin, R, Riekstina, V, Kancauskiene, Z, Paduto, D, Mocroft, A, Trofimova, T, Miller, R, Post, F, Grezesczuk, A, Lundgren, J, Inglot, M, Podlekareva, D, Bolokadze, N, Kirk, O, Karpov, I, Vassilenko, A, Klimuk, D, Skrahin, A, Kondratenko, O, Zalutskaya, A, Bondarenko, V, Kozorez, E, Tumash, O, Suetnov, O, Iljina, V, Kummik, T, Mshvidobadze, K, Lanchava, N, Goginashvili, L, Mikiashvili, L, Bablishvili, N, Rozentale, B, Zeltina, I, Janushkevich, I, Caplinskiene, I, Caplinskas, S, Wiercinska-Drapalo, A, Thompson, M, Kozlowska, J, Bura, M, Knysz, B, Garlicki, A, Loster, J, Duiculescu, D, Rakhmanova, A, Panteleeva, O, Yakovlev, A, Kozlov, A, Tyukalova, A, Vlasova, Y, Trofimov, T, Kyselyova, G, Obel, N, Gerstoft, J, Kronborg, G, Payen, M, Kabeya, K, Necsoi, C, Dabis, F, Tsaranazy, A, Cazanave, C, Furrer, H, Sagette, M, Rickenbach, M, Elzi, L, Battegay, M, Sculier, D, Calmy, A, Cavassini, M, Bruno, A, Bernasconi, E, Hoffmann, M, Vernazza, P, Fehr, J, Weber, R, Vora, N, Cooke, G, Mullaney, S, Wilkins, E, George, V, Collini, P, Dockrell, D, Campbell, L, Brum, R, Mabonga, E, Saigal, P, Kegg, S, Ainsworth, J, Waters, A, Dhar, J, Ellis, K, Spallanzani, O, Girardi, E, Rianda, A, Galati, V, Pinnetti, C, Tommasi, C, San Gerardo, A, Lapadula, G, Di Biagio, A, Parisini, A, Carbonara, S, Angarano, G, Purgatorio, M, Matteelli, A, Apostoli, A, Miro, J, Manzardo, C, Ligero, C, Gonzalez, J, Martinez-Martinez, J, Sanchez, F, Knobel, H, Salvado, M, Lopez-Colomes, J, Martinez-Lacasa, X, Cuchi, E, Falco, V, Curran, A, Tortola, M, Ocana, I, Vidal, R, Sambeat, M, Pomar, V, Coll, P, Pozamczer, D, Saumoy, M, Alcaide, F, Cayla, J, Moreno, A, Millet, J, Orcau, A, Fina, L, Romero, A, Roldan, L, Iribarren, J, Ibarguren, M, Moreno, S, Gonzalez, A, Miralles, P, Aldamiz-Echevarria, T, Losso, M, Toibaro, J, Gambardella, L, Ramos Mejia, J, Moreno Macias, L, Warley, E, Tavella, S, Garcia Messina, O, Gear, O, Laplume, H, Marson, C, Contarelia, J, Michaan, M, Scapellato, P, Bartoletti, B, Palmero, D, Elias, C, Cortes, C, Crabtree, B, Mosqueda Gomez, J, Villanueva, J, Gonzalez Hernandez, L, Badial, F, Bentzon A. K., Panteleev A., Mitsura V., Borodulina E., Skrahina A., Denisova E., Tetradov S., Podlasin R., Riekstina V., Kancauskiene Z., Paduto D., Mocroft A., Trofimova T., Miller R., Post F., Grezesczuk A., Lundgren J. D., Inglot M., Podlekareva D., Bolokadze N., Kirk O., Karpov I., Vassilenko A., Klimuk D., Skrahin A., Kondratenko O., Zalutskaya A., Bondarenko V., Kozorez E., Tumash O., Suetnov O., Iljina V., Kummik T., Mshvidobadze K., Lanchava N., Goginashvili L., Mikiashvili L., Bablishvili N., Rozentale B., Zeltina I., Janushkevich I., Caplinskiene I., Caplinskas S., Wiercinska-Drapalo A., Thompson M., Kozlowska J., Bura M., Knysz B., Garlicki A., Loster J., Duiculescu D., Rakhmanova A., Panteleeva O., Yakovlev A., Kozlov A., Tyukalova A., Vlasova Y., Trofimov T., Kyselyova G., Obel N., Gerstoft J., Kronborg G., Payen M. C., Kabeya K., Necsoi C., Dabis F., Tsaranazy A., Cazanave C., Furrer H., Sagette M., Rickenbach M., Elzi L., Battegay M., Sculier D., Calmy A., Cavassini M., Bruno A., Bernasconi E., Hoffmann M., Vernazza P., Fehr J., Weber R., Vora N., Cooke G., Mullaney S., Wilkins E., George V., Collini P., Dockrell D., Campbell L., Brum R., Mabonga E., Saigal P., Kegg S., Ainsworth J., Waters A., Dhar J., Ellis K., Spallanzani O. L., Girardi E., Rianda A., Galati V., Pinnetti C., Tommasi C., San Gerardo A. O., Lapadula G., Di Biagio A., Parisini A., Carbonara S., Angarano G., Purgatorio M., Matteelli A., Apostoli A., Miro J. M., Manzardo C., Ligero C., Gonzalez J., Martinez-Martinez J. A., Sanchez F., Knobel H., Salvado M., Lopez-Colomes J. L., Martinez-Lacasa X., Cuchi E., Falco V., Curran A., Tortola M. T., Ocana I., Vidal R., Sambeat M. A., Pomar V., Coll P., Pozamczer D., Saumoy M., Alcaide F., Cayla J., Moreno A., Millet J. P., Orcau A., Fina L., Romero A., Roldan L. L., Iribarren J. A., Ibarguren M., Moreno S., Gonzalez A., Miralles P., Aldamiz-Echevarria T., Losso M., Toibaro J., Gambardella L., Ramos Mejia J. M., Moreno Macias L., Warley E., Tavella S., Garcia Messina O., Gear O., Laplume H., Marson C., Contarelia J., Michaan M., Scapellato P., Bartoletti B., Palmero D., Elias C., Cortes C., Crabtree B., Mosqueda Gomez J. L., Villanueva J. A., Gonzalez Hernandez L. A., and Badial F.

Abstract

Background: In a 2013 survey, we reported distinct discrepancies in delivery of tuberculosis (TB) and HIV services in eastern Europe (EE) vs. western Europe (WE). Objectives: To verify the differences in TB and HIV services in EE vs. WE. Methods: Twenty-three sites completed a survey in 2018 (EE, 14; WE, nine; 88% response rate). Results were compared across as well as within the two regions. When possible, results were compared with the 2013 survey. Results: Delivery of healthcare was significantly less integrated in EE: provision of TB and HIV services at one site (36% in EE vs. 89% in WE; P = 0.034), and continued TB follow-up in one location (42% vs. 100%; P = 0.007). Although access to TB diagnostics, standard TB and HIV drugs was generally good, fewer sites in EE reported unlimited access to rifabutin/multi-drug-resistant TB (MDR-TB) drugs, HIV integrase inhibitors and opioid substitution therapy (OST). Compared with 2013, routine usage of GeneXpert was more common in EE in 2018 (54% vs. 92%; P = 0.073), as was access to moxifloxacin (46% vs. 91%; P = 0.033), linezolid (31% vs. 64%; P = 0.217), and bedaquiline (0% vs. 25%; P = 0.217). Integration of TB and HIV services (46% vs. 39%; P = 1.000) and provision of OST to patients with opioid dependency (54% vs. 46%; P = 0.695) remained unchanged. Conclusion: Delivery of TB and HIV healthcare, including integration of TB and HIV care and access to MDR-TB drugs, still differs between WE and EE, as well as between individual EE sites.

Published
2021

3. Delayed diagnosis of tuberculosis in persons living with HIV in Eastern Europe: associated factors and effect on mortality—a multicentre prospective cohort study

Author

Kraef, C, Bentzon, A, Panteleev, A, Skrahina, A, Bolokadze, N, Tetradov, S, Podlasin, R, Karpov, I, Borodulina, E, Denisova, E, Azina, I, Lundgren, J, Johansen, I, Mocroft, A, Podlekareva, D, Kirk, O, Vassilenko, A, Klimuk, D, Kondratenko, O, Zalutskaya, A, Bondarenko, V, Mitsura, V, Kozorez, E, Tumash, O, Suetnov, O, Paduto, D, Iljina, V, Kummik, T, Mshvidobadze, K, Lanchava, N, Goginashvili, L, Mikiashvili, L, Bablishvili, N, Rozentale, B, Zeltina, I, Janushkevich, I, Caplinskiene, I, Caplinskas, S, Kancauskiene, Z, Wiercinska-Drapalo, A, Thompson, M, Kozlowska, J, Grezesczuk, A, Bura, M, Knysz, B, Inglot, M, Garlicki, A, Loster, J, Uiculescu, D, Rakhmanova, A, Panteleev, O, Yakovlev, A, Kozlov, A, Tyukalova, A, Vlasova, Y, Rofimov, T, Kyselyova, G, Obel, N, Gerstoft, J, Kronborg, G, Payen, M, Abeya, K, Necsoi, C, Dabis, F, Tsaranazy, A, Cazanave, C, Furrer, H, Sagette, M, Rickenbach, M, Sculier, D, Calmy, A, Cavassini, M, Bruno, A, Bernasconi, E, Hoffmann, M, Vernazza, P, Fehr, J, Weber, R, Miller, R, Vora, N, Cooke, G, Mullaney, S, Wilkins, E, George, V, Collini, P, Dockrell, D, Post, F, Campbell, L, Brum, R, Mabonga, E, Saigal, P, Kegg, S, Ainsworth, J, Waters, A, Dhar, J, Ellis, K, Girardi, E, Rianda, A, Galati, V, Pinnetti, C, Tommasi, C, Lapadula, G, Di Biagio, A, Parisini, A, Carbonara, S, Angarano, G, Purgatorio, M, Matteelli, A, Apostoli, A, Miro, J, Manzardo, C, Ligero, C, Gonzalez, J, Martinez-Martinez, J, Sanchez, F, Knobel, H, Salvado, M, Lopez-Colomes, J, Martinez-Lacasa, X, Cuchi, E, Falco, V, Curran, A, Tortola, M, Ocana, I, Vidal, R, Sambeat, M, Pomar, V, Coll, P, Pozamczer, D, Saumoy, M, Alcaide, F, Cayla, J, Moreno, A, Millet, J, Orcau, A, Fina, L, Romero, A, Roldan, L, Iribarren, J, Ibarguren, M, Moreno, S, Gonzalez, A, Miralles, P, Aldamiz-Echevarria, T, Losso, M, Toibaro, J, Gambardella, L, Moreno Macias, L, Warley, E, Tavella, S, Garcia Messina, O, Gear, O, Laplume, H, Marson, C, Contarelia, J, Michaan, M, Scapellato, P, Bartoletti, B, Palmero, D, Elias, C, Cortes, C, Crabtree, B, Mosqueda Gomez, J, Villanueva, J, Gonzalez Hernandez, L, Badial, F, Kraef C., Bentzon A., Panteleev A., Skrahina A., Bolokadze N., Tetradov S., Podlasin R., Karpov I., Borodulina E., Denisova E., Azina I., Lundgren J., Johansen I. S., Mocroft A., Podlekareva D., Kirk O., Vassilenko A., Klimuk D., Kondratenko O., Zalutskaya A., Bondarenko V., Mitsura V., Kozorez E., Tumash O., Suetnov O., Paduto D., Iljina V., Kummik T., Mshvidobadze K., Lanchava N., Goginashvili L., Mikiashvili L., Bablishvili N., Rozentale B., Zeltina I., Janushkevich I., Caplinskiene I., Caplinskas S., Kancauskiene Z., Wiercinska-Drapalo A., Thompson M., Kozlowska J., Grezesczuk A., Bura M., Knysz B., Inglot M., Garlicki A., Loster J., uiculescu D. D., Rakhmanova A., Panteleev O., Yakovlev A., Kozlov A., Tyukalova A., Vlasova Y., rofimov T. T., Kyselyova G., Obel N., Gerstoft J., Kronborg G., Payen M. C., abeya K. K., Necsoi C., Dabis F., Tsaranazy A., Cazanave C., Furrer H., Sagette M., Rickenbach M., Sculier D., Calmy A., Cavassini M., Bruno A., Bernasconi E., Hoffmann M., Vernazza P., Fehr J., Weber R., Miller R., Vora N., Cooke G., Mullaney S., Wilkins E., George V., Collini P., Dockrell D., Post F., Campbell L., Brum R., Mabonga E., Saigal P., Kegg S., Ainsworth J., Waters A., Dhar J., Ellis K., Girardi E., Rianda A., Galati V., Pinnetti C., Tommasi C., Lapadula G., Di Biagio A., Parisini A., Carbonara S., Angarano G., Purgatorio M., Matteelli A., Apostoli A., Miro J. M., Manzardo C., Ligero C., Gonzalez J., Martinez-Martinez J. A., Sanchez F., Knobel H., Salvado M., Lopez-Colomes J. L., Martinez-Lacasa X., Cuchi E., Falco V., Curran A., Tortola M. T., Ocana I., Vidal R., Sambeat M. A., Pomar V., Coll P., Pozamczer D., Saumoy M., Alcaide F., Cayla J., Moreno A., Millet J. P., Orcau A., Fina L., Romero A., Roldan L. L., Iribarren J. A., Ibarguren M., Moreno S., Gonzalez A., Miralles P., Aldamiz-Echevarria T., Losso M., Toibaro J., Gambardella L., Moreno Macias L., Warley E., Tavella S., Garcia Messina O., Gear O., Laplume H., Marson C., Contarelia J., Michaan M., Scapellato P., Bartoletti B., Palmero D., Elias C., Cortes C., Crabtree B., Mosqueda Gomez J. L., Villanueva J. A., Gonzalez Hernandez L. A., Badial F., Kraef, C, Bentzon, A, Panteleev, A, Skrahina, A, Bolokadze, N, Tetradov, S, Podlasin, R, Karpov, I, Borodulina, E, Denisova, E, Azina, I, Lundgren, J, Johansen, I, Mocroft, A, Podlekareva, D, Kirk, O, Vassilenko, A, Klimuk, D, Kondratenko, O, Zalutskaya, A, Bondarenko, V, Mitsura, V, Kozorez, E, Tumash, O, Suetnov, O, Paduto, D, Iljina, V, Kummik, T, Mshvidobadze, K, Lanchava, N, Goginashvili, L, Mikiashvili, L, Bablishvili, N, Rozentale, B, Zeltina, I, Janushkevich, I, Caplinskiene, I, Caplinskas, S, Kancauskiene, Z, Wiercinska-Drapalo, A, Thompson, M, Kozlowska, J, Grezesczuk, A, Bura, M, Knysz, B, Inglot, M, Garlicki, A, Loster, J, Uiculescu, D, Rakhmanova, A, Panteleev, O, Yakovlev, A, Kozlov, A, Tyukalova, A, Vlasova, Y, Rofimov, T, Kyselyova, G, Obel, N, Gerstoft, J, Kronborg, G, Payen, M, Abeya, K, Necsoi, C, Dabis, F, Tsaranazy, A, Cazanave, C, Furrer, H, Sagette, M, Rickenbach, M, Sculier, D, Calmy, A, Cavassini, M, Bruno, A, Bernasconi, E, Hoffmann, M, Vernazza, P, Fehr, J, Weber, R, Miller, R, Vora, N, Cooke, G, Mullaney, S, Wilkins, E, George, V, Collini, P, Dockrell, D, Post, F, Campbell, L, Brum, R, Mabonga, E, Saigal, P, Kegg, S, Ainsworth, J, Waters, A, Dhar, J, Ellis, K, Girardi, E, Rianda, A, Galati, V, Pinnetti, C, Tommasi, C, Lapadula, G, Di Biagio, A, Parisini, A, Carbonara, S, Angarano, G, Purgatorio, M, Matteelli, A, Apostoli, A, Miro, J, Manzardo, C, Ligero, C, Gonzalez, J, Martinez-Martinez, J, Sanchez, F, Knobel, H, Salvado, M, Lopez-Colomes, J, Martinez-Lacasa, X, Cuchi, E, Falco, V, Curran, A, Tortola, M, Ocana, I, Vidal, R, Sambeat, M, Pomar, V, Coll, P, Pozamczer, D, Saumoy, M, Alcaide, F, Cayla, J, Moreno, A, Millet, J, Orcau, A, Fina, L, Romero, A, Roldan, L, Iribarren, J, Ibarguren, M, Moreno, S, Gonzalez, A, Miralles, P, Aldamiz-Echevarria, T, Losso, M, Toibaro, J, Gambardella, L, Moreno Macias, L, Warley, E, Tavella, S, Garcia Messina, O, Gear, O, Laplume, H, Marson, C, Contarelia, J, Michaan, M, Scapellato, P, Bartoletti, B, Palmero, D, Elias, C, Cortes, C, Crabtree, B, Mosqueda Gomez, J, Villanueva, J, Gonzalez Hernandez, L, Badial, F, Kraef C., Bentzon A., Panteleev A., Skrahina A., Bolokadze N., Tetradov S., Podlasin R., Karpov I., Borodulina E., Denisova E., Azina I., Lundgren J., Johansen I. S., Mocroft A., Podlekareva D., Kirk O., Vassilenko A., Klimuk D., Kondratenko O., Zalutskaya A., Bondarenko V., Mitsura V., Kozorez E., Tumash O., Suetnov O., Paduto D., Iljina V., Kummik T., Mshvidobadze K., Lanchava N., Goginashvili L., Mikiashvili L., Bablishvili N., Rozentale B., Zeltina I., Janushkevich I., Caplinskiene I., Caplinskas S., Kancauskiene Z., Wiercinska-Drapalo A., Thompson M., Kozlowska J., Grezesczuk A., Bura M., Knysz B., Inglot M., Garlicki A., Loster J., uiculescu D. D., Rakhmanova A., Panteleev O., Yakovlev A., Kozlov A., Tyukalova A., Vlasova Y., rofimov T. T., Kyselyova G., Obel N., Gerstoft J., Kronborg G., Payen M. C., abeya K. K., Necsoi C., Dabis F., Tsaranazy A., Cazanave C., Furrer H., Sagette M., Rickenbach M., Sculier D., Calmy A., Cavassini M., Bruno A., Bernasconi E., Hoffmann M., Vernazza P., Fehr J., Weber R., Miller R., Vora N., Cooke G., Mullaney S., Wilkins E., George V., Collini P., Dockrell D., Post F., Campbell L., Brum R., Mabonga E., Saigal P., Kegg S., Ainsworth J., Waters A., Dhar J., Ellis K., Girardi E., Rianda A., Galati V., Pinnetti C., Tommasi C., Lapadula G., Di Biagio A., Parisini A., Carbonara S., Angarano G., Purgatorio M., Matteelli A., Apostoli A., Miro J. M., Manzardo C., Ligero C., Gonzalez J., Martinez-Martinez J. A., Sanchez F., Knobel H., Salvado M., Lopez-Colomes J. L., Martinez-Lacasa X., Cuchi E., Falco V., Curran A., Tortola M. T., Ocana I., Vidal R., Sambeat M. A., Pomar V., Coll P., Pozamczer D., Saumoy M., Alcaide F., Cayla J., Moreno A., Millet J. P., Orcau A., Fina L., Romero A., Roldan L. L., Iribarren J. A., Ibarguren M., Moreno S., Gonzalez A., Miralles P., Aldamiz-Echevarria T., Losso M., Toibaro J., Gambardella L., Moreno Macias L., Warley E., Tavella S., Garcia Messina O., Gear O., Laplume H., Marson C., Contarelia J., Michaan M., Scapellato P., Bartoletti B., Palmero D., Elias C., Cortes C., Crabtree B., Mosqueda Gomez J. L., Villanueva J. A., Gonzalez Hernandez L. A., and Badial F.

Abstract

Background: Early diagnosis of tuberculosis (TB) is important to reduce transmission, morbidity and mortality in people living with HIV (PLWH). Methods: PLWH with a diagnosis of TB were enrolled from HIV and TB clinics in Eastern Europe and followed until 24 months. Delayed diagnosis was defined as duration of TB symptoms (cough, weight-loss or fever) for ≥ 1 month before TB diagnosis. Risk factors for delayed TB diagnosis were assessed using multivariable logistic regression. The effect of delayed diagnosis on mortality was assessed using Kaplan–Meier estimates and Cox models. Findings: 480/740 patients (64.9%; 95% CI 61.3–68.3%) experienced a delayed diagnosis. Age ≥ 50 years (vs. < 50 years, aOR = 2.51; 1.18–5.32; p = 0.016), injecting drug use (IDU) (vs. non-IDU aOR = 1.66; 1.21–2.29; p = 0.002), being ART naïve (aOR = 1.77; 1.24–2.54; p = 0.002), disseminated TB (vs. pulmonary TB, aOR = 1.56, 1.10–2.19, p = 0.012), and presenting with weight loss (vs. no weight loss, aOR = 1.63; 1.18–2.24; p = 0.003) were associated with delayed diagnosis. PLWH with a delayed diagnosis were at 36% increased risk of death (hazard ratio = 1.36; 1.04–1.77; p = 0.023, adjusted hazard ratio 1.27; 0.95–1.70; p = 0.103). Conclusion: Nearly two thirds of PLWH with TB in Eastern Europe had a delayed TB diagnosis, in particular those of older age, people who inject drugs, ART naïve, with disseminated disease, and presenting with weight loss. Patients with delayed TB diagnosis were subsequently at higher risk of death in unadjusted analysis. There is a need for optimisation of the current TB diagnostic cascade and HIV care in PLWH in Eastern Europe.

Published
2021

4. Delayed diagnosis of tuberculosis in persons living with HIV in Eastern Europe: associated factors and effect on mortality-a multicentre prospective cohort study

Author

Kraef, Christian, Bentzon, Adrian, Panteleev, Alexander, Skrahina, Alena, Bolokadze, Natalie, Tetradov, Simona, Podlasin, Regina, Karpov, Igor, Borodulina, Elena, Denisova, Elena, Azina, Inga, Lundgren, Jens, Johansen, Isik Somuncu, Mocroft, Amanda, Podlekareva, Daria, Kirk, Ole, Vassilenko, A., Klimuk, D., Kondratenko, O., Zalutskaya, A., Bondarenko, V., Mitsura, V., Kozorez, E., Tumash, O., Suetnov, O., Paduto, D., Iljina, V., Kummik, T., Mshvidobadze, K., Lanchava, N., Goginashvili, L., Mikiashvili, L., Bablishvili, Nino, Rozentale, B., Zeltina, I., Janushkevich, I., Caplinskiene, I., Caplinskas, S., Kancauskiene, Z., Wiercinska-Drapalo, A., Thompson, M., Kozlowska, J., Grezesczuk, A., Bura, M., Knysz, B., Inglot, M., Garlicki, A., Loster, J., uiculescu, D.D., Rakhmanova, A., Panteleev, O., Yakovlev, A., Kozlov, A., Tyukalova, A., Vlasova, Y., rofimov, T.T., Kyselyova, G., Obel, N., Gerstoft, J., Kronborg, G., Payen, M.C., abeya, K.K., Necsoi, C., Dabis, F., Tsaranazy, A., Cazanave, C., Furrer, H., Sagette, M., Rickenbach, M., Sculier, D., Calmy, A., Cavassini, Matthias, Bruno, A., Bernasconi, E., Hoffmann, M., Vernazza, P., Fehr, J., Weber, R., Miller, R., Vora, N., Cooke, G., Mullaney, S., Wilkins, E., George, V., Collini, P., Dockrell, D., Post, F., Campbell, L., Brum, R., Mabonga, E., Saigal, P., Kegg, S., Ainsworth, J., Waters, A., Dhar, J., Ellis, K., Girardi, E., Rianda, A., Galati, V., Pinnetti, C., Tommasi, C., Lapadula, G., Di Biagio, A., Parisini, A., Carbonara, S., Angarano, G., Purgatorio, M., Matteelli, A., Apostoli, A., Miro, J.M., Manzardo, C., Ligero, C., Gonzalez, J., Martinez-Martinez, J.A., Sanchez, F., Knobel Freud, Hernando, Salvadó, M., Lopez-Colomes, J.L., Martínez-Lacasa, X., Cuchí, E., Falcó, Vicenç, Curran, Adrian, Tortola, M.T., Ocaña Rivera, Immaculada, Vidal, R., Sambeat, M.A., Pomar, Virginia, Coll, P., Pozamczer, D., Saumoy, M., Alcaide, Fernando, Caylà, Joan A, Moreno Camacho, Asunción, Millet, Joan-Pau, Orcau, Àngels, Fina, L., Romero, A., Roldan, L.L., Iribarren, J.A., Ibarguren, M., Moreno, S., González, A., Miralles, P., Aldámiz-Echevarría, T., Losso, M., Toibaro, J., Gambardella, L., Moreno Macias, L., Warley, E., Tavella, S., Garcia Messina, O., Gear, O., Laplume, H., Marson, C., Contarelia, J., Michaan, M., Scapellato, P., Bartoletti, B., Palmero, D., Elias, C., Cortes, C., Crabtree, B., Mosqueda Gomez, J.L., Villanueva, J.A., Gonzalez Hernandez, L.A., Badial, F., Kraef, C, Bentzon, A, Panteleev, A, Skrahina, A, Bolokadze, N, Tetradov, S, Podlasin, R, Karpov, I, Borodulina, E, Denisova, E, Azina, I, Lundgren, J, Johansen, I, Mocroft, A, Podlekareva, D, Kirk, O, Vassilenko, A, Klimuk, D, Kondratenko, O, Zalutskaya, A, Bondarenko, V, Mitsura, V, Kozorez, E, Tumash, O, Suetnov, O, Paduto, D, Iljina, V, Kummik, T, Mshvidobadze, K, Lanchava, N, Goginashvili, L, Mikiashvili, L, Bablishvili, N, Rozentale, B, Zeltina, I, Janushkevich, I, Caplinskiene, I, Caplinskas, S, Kancauskiene, Z, Wiercinska-Drapalo, A, Thompson, M, Kozlowska, J, Grezesczuk, A, Bura, M, Knysz, B, Inglot, M, Garlicki, A, Loster, J, Uiculescu, D, Rakhmanova, A, Panteleev, O, Yakovlev, A, Kozlov, A, Tyukalova, A, Vlasova, Y, Rofimov, T, Kyselyova, G, Obel, N, Gerstoft, J, Kronborg, G, Payen, M, Abeya, K, Necsoi, C, Dabis, F, Tsaranazy, A, Cazanave, C, Furrer, H, Sagette, M, Rickenbach, M, Sculier, D, Calmy, A, Cavassini, M, Bruno, A, Bernasconi, E, Hoffmann, M, Vernazza, P, Fehr, J, Weber, R, Miller, R, Vora, N, Cooke, G, Mullaney, S, Wilkins, E, George, V, Collini, P, Dockrell, D, Post, F, Campbell, L, Brum, R, Mabonga, E, Saigal, P, Kegg, S, Ainsworth, J, Waters, A, Dhar, J, Ellis, K, Girardi, E, Rianda, A, Galati, V, Pinnetti, C, Tommasi, C, Lapadula, G, Di Biagio, A, Parisini, A, Carbonara, S, Angarano, G, Purgatorio, M, Matteelli, A, Apostoli, A, Miro, J, Manzardo, C, Ligero, C, Gonzalez, J, Martinez-Martinez, J, Sanchez, F, Knobel, H, Salvado, M, Lopez-Colomes, J, Martinez-Lacasa, X, Cuchi, E, Falco, V, Curran, A, Tortola, M, Ocana, I, Vidal, R, Sambeat, M, Pomar, V, Coll, P, Pozamczer, D, Saumoy, M, Alcaide, F, Cayla, J, Moreno, A, Millet, J, Orcau, A, Fina, L, Romero, A, Roldan, L, Iribarren, J, Ibarguren, M, Moreno, S, Gonzalez, A, Miralles, P, Aldamiz-Echevarria, T, Losso, M, Toibaro, J, Gambardella, L, Moreno Macias, L, Warley, E, Tavella, S, Garcia Messina, O, Gear, O, Laplume, H, Marson, C, Contarelia, J, Michaan, M, Scapellato, P, Bartoletti, B, Palmero, D, Elias, C, Cortes, C, Crabtree, B, Mosqueda Gomez, J, Villanueva, J, Gonzalez Hernandez, L, and Badial, F

Subjects
medicine.medical_specialty, Tuberculosis, Delayed Diagnosis, Aged, Europe, Eastern, Humans, Middle Aged, Prospective Studies, HIV Infections, Tuberculosi, Epidemiology, Tuberculosis/diagnosis, HIV Infections/complications, Infectious and parasitic diseases, RC109-216, Eastern Europe, Eastern, Logistic regression, Europa de l'Est, Medical microbiology, Weight loss, Internal medicine, medicine, VIH (Virus), HIV Infection, Europe, Eastern/epidemiology, Prospective cohort study, Epidemiologia, business.industry, Proportional hazards model, Transmission (medicine), HIV (Viruses), Research, Hazard ratio, Delayed Diagnosi, medicine.disease, Europe, Prospective Studie, Infectious Diseases, medicine.symptom, business, Human
Abstract

Background Early diagnosis of tuberculosis (TB) is important to reduce transmission, morbidity and mortality in people living with HIV (PLWH). Methods PLWH with a diagnosis of TB were enrolled from HIV and TB clinics in Eastern Europe and followed until 24 months. Delayed diagnosis was defined as duration of TB symptoms (cough, weight-loss or fever) for ≥ 1 month before TB diagnosis. Risk factors for delayed TB diagnosis were assessed using multivariable logistic regression. The effect of delayed diagnosis on mortality was assessed using Kaplan–Meier estimates and Cox models. Findings 480/740 patients (64.9%; 95% CI 61.3–68.3%) experienced a delayed diagnosis. Age ≥ 50 years (vs. Conclusion Nearly two thirds of PLWH with TB in Eastern Europe had a delayed TB diagnosis, in particular those of older age, people who inject drugs, ART naïve, with disseminated disease, and presenting with weight loss. Patients with delayed TB diagnosis were subsequently at higher risk of death in unadjusted analysis. There is a need for optimisation of the current TB diagnostic cascade and HIV care in PLWH in Eastern Europe.

Published
2021
Full Text
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5. Healthcare delivery for HIV-positive people with tuberculosis in Europe

Author

Bentzon, A. K., Panteleev, A., Mitsura, V., Borodulina, E., Skrahina, A., Denisova, E., Tetradov, S., Podlasin, R., Riekstina, V., Kancauskiene, Z., Paduto, D., Mocroft, A., Trofimova, T., Miller, R., Post, F., Grezesczuk, A., Lundgren, J. D., Inglot, M., Podlekareva, D., Bolokadze, N., Kirk, O., Karpov, I., Vassilenko, A., Klimuk, D., Skrahin, A., Kondratenko, O., Zalutskaya, A., Bondarenko, V., Kozorez, E., Tumash, O., Suetnov, O., Iljina, V., Kummik, T., Mshvidobadze, K., Lanchava, N., Goginashvili, L., Mikiashvili, L., Bablishvili, N., Rozentale, B., Zeltina, I., Janushkevich, I., Caplinskiene, I., Caplinskas, S., Wiercinska-Drapalo, A., Thompson, M., Kozlowska, J., Bura, M., Knysz, B., Garlicki, A., Loster, J., Duiculescu, D., Rakhmanova, A., Panteleeva, O., Yakovlev, A., Kozlov, A., Tyukalova, A., Vlasova, Y., Trofimov, T., Kyselyova, G., Obel, N., Gerstoft, J., Kronborg, G., Payen, M. C., Kabeya, K., Necsoi, C., Dabis, F., Tsaranazy, A., Cazanave, C., Furrer, H., Sagette, M., Rickenbach, M., Elzi, L., Battegay, M., Sculier, D., Calmy, A., Cavassini, M., Bruno, A., Bernasconi, E., Hoffmann, M., Vernazza, P., Fehr, J., Weber, R., Vora, N., Cooke, G., Mullaney, S., Wilkins, E., George, V., Collini, P., Dockrell, D., Campbell, L., Brum, R., Mabonga, E., Saigal, P., Kegg, S., Ainsworth, J., Waters, A., Dhar, J., Ellis, K., Spallanzani, O. L., Girardi, E., Rianda, A., Galati, V., Pinnetti, C., Tommasi, C., San Gerardo, A. O., Lapadula, G., Di Biagio, A., Parisini, A., Carbonara, S., Angarano, G., Purgatorio, M., Matteelli, A., Apostoli, A., Miro, J. M., Manzardo, C., Ligero, C., Gonzalez, J., Martinez-Martinez, J. A., Sanchez, F., Knobel, H., Salvado, M., Lopez-Colomes, J. L., Martinez-Lacasa, X., Cuchi, E., Falco, V., Curran, A., Tortola, M. T., Ocana, I., Vidal, R., Sambeat, M. A., Pomar, V., Coll, P., Pozamczer, D., Saumoy, M., Alcaide, F., Cayla, J., Moreno, A., Millet, J. P., Orcau, A., Fina, L., Romero, A., Roldan, L. L., Iribarren, J. A., Ibarguren, M., Moreno, S., Gonzalez, A., Miralles, P., Aldamiz-Echevarria, T., Losso, M., Toibaro, J., Gambardella, L., Ramos Mejia, J. M., Moreno Macias, L., Warley, E., Tavella, S., Garcia Messina, O., Gear, O., Laplume, H., Marson, C., Contarelia, J., Michaan, M., Scapellato, P., Bartoletti, B., Palmero, D., Elias, C., Cortes, C., Crabtree, B., Mosqueda Gomez, J. L., Villanueva, J. A., Gonzalez Hernandez, L. A., and Badial, F.

Subjects
0301 basic medicine, medicine.medical_specialty, Rifabutin, Tuberculosis, Tuberculosi, Epidemiology, Antitubercular Agents, HIV Infections, Article, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Moxifloxacin, Internal medicine, medicine, clinical management, VIH (Virus), Humans, Pharmacology (medical), 030212 general & internal medicine, Epidemiologia, coinfection, eastern Europe, HIV, tuberculosis, western Europe, Response rate (survey), GeneXpert MTB/RIF, business.industry, HIV (Viruses), Health Policy, medicine.disease, 030112 virology, Europe, Infectious Diseases, HIV-positive people, chemistry, Coinfection, Bedaquiline, business, Europa, Delivery of Health Care, medicine.drug
Abstract

Background: In a 2013 survey, we reported distinct discrepancies in delivery of tuberculosis (TB) and HIV services in eastern Europe (EE) vs. western Europe (WE). Objectives: To verify the differences in TB and HIV services in EE vs. WE. Methods: Twenty-three sites completed a survey in 2018 (EE, 14; WE, nine; 88% response rate). Results were compared across as well as within the two regions. When possible, results were compared with the 2013 survey. Results: Delivery of healthcare was significantly less integrated in EE: provision of TB and HIV services at one site (36% in EE vs. 89% in WE; P = 0.034), and continued TB follow-up in one location (42% vs. 100%; P = 0.007). Although access to TB diagnostics, standard TB and HIV drugs was generally good, fewer sites in EE reported unlimited access to rifabutin/multi-drug-resistant TB (MDR-TB) drugs, HIV integrase inhibitors and opioid substitution therapy (OST). Compared with 2013, routine usage of GeneXpert was more common in EE in 2018 (54% vs. 92%; P = 0.073), as was access to moxifloxacin (46% vs. 91%; P = 0.033), linezolid (31% vs. 64%; P = 0.217), and bedaquiline (0% vs. 25%; P = 0.217). Integration of TB and HIV services (46% vs. 39%; P = 1.000) and provision of OST to patients with opioid dependency (54% vs. 46%; P = 0.695) remained unchanged. Conclusion: Delivery of TB and HIV healthcare, including integration of TB and HIV care and access to MDR-TB drugs, still differs between WE and EE, as well as between individual EE sites.

Published
2020
Full Text
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6. Healthcare delivery for HIV-positive people with tuberculosis in Europe

Author

Bentzon, A. K., Panteleev, A., Mitsura, V., Borodulina, E., Skrahina, A., Denisova, E., Tetradov, S., Podlasin, R., Riekstina, V., Kancauskiene, Z., Paduto, D., Mocroft, A., Trofimova, T., Miller, R., Post, F., Grezesczuk, A., Lundgren, J. D., Inglot, M., Podlekareva, D., Bolokadze, N., Kirk, O., Karpov, I., Vassilenko, A., Klimuk, D., Skrahin, A., Kondratenko, O., Zalutskaya, A., Bondarenko, V., Kozorez, E., Tumash, O., Suetnov, O., Iljina, V., Kummik, T., Mshvidobadze, K., Lanchava, N., Goginashvili, L., Mikiashvili, L., Bablishvili, N., Rozentale, B., Zeltina, I., Janushkevich, I., Caplinskiene, I., Caplinskas, S., Wiercinska-Drapalo, A., Obel, N., Gerstoft, J., Kronborg, G., Hoffmann, M., Campbell, L., González, A., Bentzon, A. K., Panteleev, A., Mitsura, V., Borodulina, E., Skrahina, A., Denisova, E., Tetradov, S., Podlasin, R., Riekstina, V., Kancauskiene, Z., Paduto, D., Mocroft, A., Trofimova, T., Miller, R., Post, F., Grezesczuk, A., Lundgren, J. D., Inglot, M., Podlekareva, D., Bolokadze, N., Kirk, O., Karpov, I., Vassilenko, A., Klimuk, D., Skrahin, A., Kondratenko, O., Zalutskaya, A., Bondarenko, V., Kozorez, E., Tumash, O., Suetnov, O., Iljina, V., Kummik, T., Mshvidobadze, K., Lanchava, N., Goginashvili, L., Mikiashvili, L., Bablishvili, N., Rozentale, B., Zeltina, I., Janushkevich, I., Caplinskiene, I., Caplinskas, S., Wiercinska-Drapalo, A., Obel, N., Gerstoft, J., Kronborg, G., Hoffmann, M., Campbell, L., and González, A.

Abstract

Background: In a 2013 survey, we reported distinct discrepancies in delivery of tuberculosis (TB) and HIV services in eastern Europe (EE) vs. western Europe (WE). Objectives: To verify the differences in TB and HIV services in EE vs. WE. Methods: Twenty-three sites completed a survey in 2018 (EE, 14; WE, nine; 88% response rate). Results were compared across as well as within the two regions. When possible, results were compared with the 2013 survey. Results: Delivery of healthcare was significantly less integrated in EE: provision of TB and HIV services at one site (36% in EE vs. 89% in WE; P = 0.034), and continued TB follow-up in one location (42% vs. 100%; P = 0.007). Although access to TB diagnostics, standard TB and HIV drugs was generally good, fewer sites in EE reported unlimited access to rifabutin/multi-drug-resistant TB (MDR-TB) drugs, HIV integrase inhibitors and opioid substitution therapy (OST). Compared with 2013, routine usage of GeneXpert was more common in EE in 2018 (54% vs. 92%; P = 0.073), as was access to moxifloxacin (46% vs. 91%; P = 0.033), linezolid (31% vs. 64%; P = 0.217), and bedaquiline (0% vs. 25%; P = 0.217). Integration of TB and HIV services (46% vs. 39%; P = 1.000) and provision of OST to patients with opioid dependency (54% vs. 46%; P = 0.695) remained unchanged. Conclusion: Delivery of TB and HIV healthcare, including integration of TB and HIV care and access to MDR-TB drugs, still differs between WE and EE, as well as between individual EE sites.

Published
2021

7. Delayed diagnosis of tuberculosis in persons living with HIV in Eastern Europe:associated factors and effect on mortality—a multicentre prospective cohort study

Author

Kraef, Christian, Bentzon, Adrian, Panteleev, Alexander, Skrahina, Alena, Bolokadze, Natalie, Tetradov, Simona, Podlasin, Regina, Karpov, Igor, Borodulina, Elena, Denisova, Elena, Azina, Inga, Lundgren, Jens, Johansen, Isik Somuncu, Mocroft, Amanda, Podlekareva, Daria, Kirk, Ole, Vassilenko, A., Klimuk, D., Kondratenko, O., Zalutskaya, A., Bondarenko, V., Mitsura, V., Kozorez, E., Tumash, O., Suetnov, O., Paduto, D., Iljina, V., Kummik, T., Mshvidobadze, K., Lanchava, N., Goginashvili, L., Mikiashvili, L., Bablishvili, N., Rozentale, B., Zeltina, I., Janushkevich, I., Caplinskiene, I., Caplinskas, S., Kancauskiene, Z., Wiercinska-Drapalo, A., Thompson, M., Kozlowska, J., Grezesczuk, A., Bura, M., Knysz, B., Inglot, M., Garlicki, A., Obel, N., Gerstoft, J., Kronborg, G., Kraef, Christian, Bentzon, Adrian, Panteleev, Alexander, Skrahina, Alena, Bolokadze, Natalie, Tetradov, Simona, Podlasin, Regina, Karpov, Igor, Borodulina, Elena, Denisova, Elena, Azina, Inga, Lundgren, Jens, Johansen, Isik Somuncu, Mocroft, Amanda, Podlekareva, Daria, Kirk, Ole, Vassilenko, A., Klimuk, D., Kondratenko, O., Zalutskaya, A., Bondarenko, V., Mitsura, V., Kozorez, E., Tumash, O., Suetnov, O., Paduto, D., Iljina, V., Kummik, T., Mshvidobadze, K., Lanchava, N., Goginashvili, L., Mikiashvili, L., Bablishvili, N., Rozentale, B., Zeltina, I., Janushkevich, I., Caplinskiene, I., Caplinskas, S., Kancauskiene, Z., Wiercinska-Drapalo, A., Thompson, M., Kozlowska, J., Grezesczuk, A., Bura, M., Knysz, B., Inglot, M., Garlicki, A., Obel, N., Gerstoft, J., and Kronborg, G.

Abstract

Background: Early diagnosis of tuberculosis (TB) is important to reduce transmission, morbidity and mortality in people living with HIV (PLWH). Methods: PLWH with a diagnosis of TB were enrolled from HIV and TB clinics in Eastern Europe and followed until 24 months. Delayed diagnosis was defined as duration of TB symptoms (cough, weight-loss or fever) for ≥ 1 month before TB diagnosis. Risk factors for delayed TB diagnosis were assessed using multivariable logistic regression. The effect of delayed diagnosis on mortality was assessed using Kaplan–Meier estimates and Cox models. Findings: 480/740 patients (64.9%; 95% CI 61.3–68.3%) experienced a delayed diagnosis. Age ≥ 50 years (vs. < 50 years, aOR = 2.51; 1.18–5.32; p = 0.016), injecting drug use (IDU) (vs. non-IDU aOR = 1.66; 1.21–2.29; p = 0.002), being ART naïve (aOR = 1.77; 1.24–2.54; p = 0.002), disseminated TB (vs. pulmonary TB, aOR = 1.56, 1.10–2.19, p = 0.012), and presenting with weight loss (vs. no weight loss, aOR = 1.63; 1.18–2.24; p = 0.003) were associated with delayed diagnosis. PLWH with a delayed diagnosis were at 36% increased risk of death (hazard ratio = 1.36; 1.04–1.77; p = 0.023, adjusted hazard ratio 1.27; 0.95–1.70; p = 0.103). Conclusion: Nearly two thirds of PLWH with TB in Eastern Europe had a delayed TB diagnosis, in particular those of older age, people who inject drugs, ART naïve, with disseminated disease, and presenting with weight loss. Patients with delayed TB diagnosis were subsequently at higher risk of death in unadjusted analysis. There is a need for optimisation of the current TB diagnostic cascade and HIV care in PLWH in Eastern Europe.

Published
2021

8. Major differences in organization and availability of health care and medicines for HIV/TB coinfected patients across Europe

Author

Mansfeld M., Skrahina A., Shepherd L., Schultze A., Panteleev A., Miller R., Miro J., Zeltina I., Tetradov S., Furrer H., Kirk O., Grzeszczuk A., Bolokadze N., Matteelli A., Post F., Lundgren J., Mocroft A., Efsen A., Podlekareva D., Losso M. H., Toibaro J. J., Palmero D., Bartoletti B. J., E. Warley, Gear O., Messina O. G., Michans M., Laplume H., David D., Marson C., Scapelatto F. P., Dalessandro D., Lupo S., Costilla Campero G., Herbst M., Remondegui C., Elias C., Karpov I., Vassilenko A., Skrahina E., Skrahin A., Zalutskya A., Kondratenko O., Mitsura V., Bondarenko V., Suetnov O., Paduto D., Dewit S., Payen M. C., Noscoi C., Kabeya K., M. Wolff, Cortes C., Obel N., Kronborg G., Iljna V., Kummik T., Bryand M., Dabis F., Lanchava N., Bablishvili N., Goginashvili L., Mikiashvili L., Mshvidobadze K., Girardi E., Di Biagio A., Apostoli A., Barzoni S., Lapadula G., Purgatorio M., Carbonara S., Rozentale B., Janushkevich I., Caplinskas S., Kancauskienne Z., Caplinskienne I., Crabtree B., Pina A., Madero J. S., Mosqueda J., Villanueva J. A., Bura M., Garlicki A., Inglot M., Knysz B., Kozlowska J., Loster J., Mularska E., Podlasin R., Thompson M., Wiercinska-Drapalo A., Duiculescu D., Rakhmanova A., Yakovlev A., Turkalova A., Vlasova Y., Trotimora T., Borodulina E., Chumanova L., Mashkova Y., Miro J. M., Cayla J. A., Moreno A., Millet J. P., Orcau A., Fina L., del Bano L., Roldan L. L., Romero A., Martinez J. A., Manzardo C., Gonzalez J., Tudo G., Knobel H., Sanchez F., Salvado M., Curran A., Tortola M. T., Pozamczer D., Saumoy M., Alcaide F., Martinez-Lacasa X., Cuchi E., Sambeat M. A., Pomar V., Coll P., Miralles P., Moreno S., Iribarren J. A., Ibarguren M., Aldamiz T., Rickenbach M., Sagette M., Post F. A., Miller R. F., Chapman A., Dockrell D., Wilkins E., Cooke G., Ainsworth J., Macallen D., Dhar J., Vora N., Mullaney S., Kegg S., Kyselyova G., Mansfeld, M, Skrahina, A, Shepherd, L, Schultze, A, Panteleev, A, Miller, R, Miro, J, Zeltina, I, Tetradov, S, Furrer, H, Kirk, O, Grzeszczuk, A, Bolokadze, N, Matteelli, A, Post, F, Lundgren, J, Mocroft, A, Efsen, A, Podlekareva, D, Losso, M, Toibaro, J, Palmero, D, Bartoletti, B, E., W, Gear, O, Messina, O, Michans, M, Laplume, H, David, D, Marson, C, Scapelatto, F, Dalessandro, D, Lupo, S, Costilla Campero, G, Herbst, M, Remondegui, C, Elias, C, Karpov, I, Vassilenko, A, Skrahina, E, Skrahin, A, Zalutskya, A, Kondratenko, O, Mitsura, V, Bondarenko, V, Suetnov, O, Paduto, D, Dewit, S, Payen, M, Noscoi, C, Kabeya, K, M., W, Cortes, C, Obel, N, Kronborg, G, Iljna, V, Kummik, T, Bryand, M, Dabis, F, Lanchava, N, Bablishvili, N, Goginashvili, L, Mikiashvili, L, Mshvidobadze, K, Girardi, E, Di Biagio, A, Apostoli, A, Barzoni, S, Lapadula, G, Purgatorio, M, Carbonara, S, Rozentale, B, Janushkevich, I, Caplinskas, S, Kancauskienne, Z, Caplinskienne, I, Crabtree, B, Pina, A, Madero, J, Mosqueda, J, Villanueva, J, Bura, M, Garlicki, A, Inglot, M, Knysz, B, Kozlowska, J, Loster, J, Mularska, E, Podlasin, R, Thompson, M, Wiercinska-Drapalo, A, Duiculescu, D, Rakhmanova, A, Yakovlev, A, Turkalova, A, Vlasova, Y, Trotimora, T, Borodulina, E, Chumanova, L, Mashkova, Y, Cayla, J, Moreno, A, Millet, J, Orcau, A, Fina, L, del Bano, L, Roldan, L, Romero, A, Martinez, J, Manzardo, C, Gonzalez, J, Tudo, G, Knobel, H, Sanchez, F, Salvado, M, Curran, A, Tortola, M, Pozamczer, D, Saumoy, M, Alcaide, F, Martinez-Lacasa, X, Cuchi, E, Sambeat, M, Pomar, V, Coll, P, Miralles, P, Moreno, S, Iribarren, J, Ibarguren, M, Aldamiz, T, Rickenbach, M, Sagette, M, Chapman, A, Dockrell, D, Wilkins, E, Cooke, G, Ainsworth, J, Macallen, D, Dhar, J, Vora, N, Mullaney, S, Kegg, S, and Kyselyova, G

Subjects
Tuberculosi, Coinfection, Health Policy, Antitubercular Agents, HIV, 1103 Clinical Sciences, HIV Infections, Eastern, Health Surveys, Article, Europe, Infectious Diseases, Cross-Sectional Studies, Rifabutin, Delivery of health care, Integrated, Tuberculosis, Europe, Eastern, Humans, Opiate Substitution Treatment, Pharmacology (medical), Virology, 610 Medicine & health
Abstract

Objectives: The aim of the study was to investigate the organization and delivery of HIV and tuberculosis (TB) health care and to analyse potential differences between treatment centres in Eastern (EE) and Western Europe (WE). Methods: Thirty-eight European HIV and TB treatment centres participating in the TB:HIV study within EuroCoord completed a survey on health care management for coinfected patients in 2013 (EE: 17 respondents; WE:21; 76% of all TB:HIV centres). Descriptive statistics were obtained for regional comparisons. The reported data on health care strategies were compared with actual clinical practice at patient level via data derived from the TB:HIV study. Results: Respondent centres in EE comprised: Belarus (n=3), Estonia (1), Georgia (1), Latvia (1), Lithuania (1), Poland (4), Romania (1), the Russian Federation (4) and Ukraine (1); those in WE comprised: Belgium (1), Denmark (1), France (1), Italy (7), Spain (2), Switzerland (1) and UK (8). Compared with WE, treatment of HIV and TB in EE are less often located at the same site (47% in EE versus 100% in WE; P

Published
2015

9. Major differences in organization and availability of health care and medicines for HIV/TB coinfected patients across Europe

Author

Mansfeld, M, Skrahina, A, Shepherd, L, Schultze, A, Panteleev, A, Miller, R, Miro, J, Zeltina, I, Tetradov, S, Furrer, H, Kirk, O, Grzeszczuk, A, Bolokadze, N, Matteelli, A, Post, F, Lundgren, J, Mocroft, A, Efsen, A, Podlekareva, D, Losso, M, Toibaro, J, Palmero, D, Bartoletti, B, E., W, Gear, O, Messina, O, Michans, M, Laplume, H, David, D, Marson, C, Scapelatto, F, Dalessandro, D, Lupo, S, Costilla Campero, G, Herbst, M, Remondegui, C, Elias, C, Karpov, I, Vassilenko, A, Skrahina, E, Skrahin, A, Zalutskya, A, Kondratenko, O, Mitsura, V, Bondarenko, V, Suetnov, O, Paduto, D, Dewit, S, Payen, M, Noscoi, C, Kabeya, K, M., W, Cortes, C, Obel, N, Kronborg, G, Iljna, V, Kummik, T, Bryand, M, Dabis, F, Lanchava, N, Bablishvili, N, Goginashvili, L, Mikiashvili, L, Mshvidobadze, K, Girardi, E, Di Biagio, A, Apostoli, A, Barzoni, S, Lapadula, G, Purgatorio, M, Carbonara, S, Rozentale, B, Janushkevich, I, Caplinskas, S, Kancauskienne, Z, Caplinskienne, I, Crabtree, B, Pina, A, Madero, J, Mosqueda, J, Villanueva, J, Bura, M, Garlicki, A, Inglot, M, Knysz, B, Kozlowska, J, Loster, J, Mularska, E, Podlasin, R, Thompson, M, Wiercinska-Drapalo, A, Duiculescu, D, Rakhmanova, A, Yakovlev, A, Turkalova, A, Vlasova, Y, Trotimora, T, Borodulina, E, Chumanova, L, Mashkova, Y, Cayla, J, Moreno, A, Millet, J, Orcau, A, Fina, L, del Bano, L, Roldan, L, Romero, A, Martinez, J, Manzardo, C, Gonzalez, J, Tudo, G, Knobel, H, Sanchez, F, Salvado, M, Curran, A, Tortola, M, Pozamczer, D, Saumoy, M, Alcaide, F, Martinez-Lacasa, X, Cuchi, E, Sambeat, M, Pomar, V, Coll, P, Miralles, P, Moreno, S, Iribarren, J, Ibarguren, M, Aldamiz, T, Rickenbach, M, Sagette, M, Chapman, A, Dockrell, D, Wilkins, E, Cooke, G, Ainsworth, J, Macallen, D, Dhar, J, Vora, N, Mullaney, S, Kegg, S, Kyselyova, G, Mansfeld M., Skrahina A., Shepherd L., Schultze A., Panteleev A., Miller R., Miro J., Zeltina I., Tetradov S., Furrer H., Kirk O., Grzeszczuk A., Bolokadze N., Matteelli A., Post F., Lundgren J., Mocroft A., Efsen A., Podlekareva D., Losso M. H., Toibaro J. J., Palmero D., Bartoletti B. J., E. Warley, Gear O., Messina O. G., Michans M., Laplume H., David D., Marson C., Scapelatto F. P., Dalessandro D., Lupo S., Costilla Campero G., Herbst M., Remondegui C., Elias C., Karpov I., Vassilenko A., Skrahina E., Skrahin A., Zalutskya A., Kondratenko O., Mitsura V., Bondarenko V., Suetnov O., Paduto D., Dewit S., Payen M. C., Noscoi C., Kabeya K., M. Wolff, Cortes C., Obel N., Kronborg G., Iljna V., Kummik T., Bryand M., Dabis F., Lanchava N., Bablishvili N., Goginashvili L., Mikiashvili L., Mshvidobadze K., Girardi E., Di Biagio A., Apostoli A., Barzoni S., Lapadula G., Purgatorio M., Carbonara S., Rozentale B., Janushkevich I., Caplinskas S., Kancauskienne Z., Caplinskienne I., Crabtree B., Pina A., Madero J. S., Mosqueda J., Villanueva J. A., Bura M., Garlicki A., Inglot M., Knysz B., Kozlowska J., Loster J., Mularska E., Podlasin R., Thompson M., Wiercinska-Drapalo A., Duiculescu D., Rakhmanova A., Yakovlev A., Turkalova A., Vlasova Y., Trotimora T., Borodulina E., Chumanova L., Mashkova Y., Miro J. M., Cayla J. A., Moreno A., Millet J. P., Orcau A., Fina L., del Bano L., Roldan L. L., Romero A., Martinez J. A., Manzardo C., Gonzalez J., Tudo G., Knobel H., Sanchez F., Salvado M., Curran A., Tortola M. T., Pozamczer D., Saumoy M., Alcaide F., Martinez-Lacasa X., Cuchi E., Sambeat M. A., Pomar V., Coll P., Miralles P., Moreno S., Iribarren J. A., Ibarguren M., Aldamiz T., Rickenbach M., Sagette M., Post F. A., Miller R. F., Chapman A., Dockrell D., Wilkins E., Cooke G., Ainsworth J., Macallen D., Dhar J., Vora N., Mullaney S., Kegg S., Kyselyova G., Mansfeld, M, Skrahina, A, Shepherd, L, Schultze, A, Panteleev, A, Miller, R, Miro, J, Zeltina, I, Tetradov, S, Furrer, H, Kirk, O, Grzeszczuk, A, Bolokadze, N, Matteelli, A, Post, F, Lundgren, J, Mocroft, A, Efsen, A, Podlekareva, D, Losso, M, Toibaro, J, Palmero, D, Bartoletti, B, E., W, Gear, O, Messina, O, Michans, M, Laplume, H, David, D, Marson, C, Scapelatto, F, Dalessandro, D, Lupo, S, Costilla Campero, G, Herbst, M, Remondegui, C, Elias, C, Karpov, I, Vassilenko, A, Skrahina, E, Skrahin, A, Zalutskya, A, Kondratenko, O, Mitsura, V, Bondarenko, V, Suetnov, O, Paduto, D, Dewit, S, Payen, M, Noscoi, C, Kabeya, K, M., W, Cortes, C, Obel, N, Kronborg, G, Iljna, V, Kummik, T, Bryand, M, Dabis, F, Lanchava, N, Bablishvili, N, Goginashvili, L, Mikiashvili, L, Mshvidobadze, K, Girardi, E, Di Biagio, A, Apostoli, A, Barzoni, S, Lapadula, G, Purgatorio, M, Carbonara, S, Rozentale, B, Janushkevich, I, Caplinskas, S, Kancauskienne, Z, Caplinskienne, I, Crabtree, B, Pina, A, Madero, J, Mosqueda, J, Villanueva, J, Bura, M, Garlicki, A, Inglot, M, Knysz, B, Kozlowska, J, Loster, J, Mularska, E, Podlasin, R, Thompson, M, Wiercinska-Drapalo, A, Duiculescu, D, Rakhmanova, A, Yakovlev, A, Turkalova, A, Vlasova, Y, Trotimora, T, Borodulina, E, Chumanova, L, Mashkova, Y, Cayla, J, Moreno, A, Millet, J, Orcau, A, Fina, L, del Bano, L, Roldan, L, Romero, A, Martinez, J, Manzardo, C, Gonzalez, J, Tudo, G, Knobel, H, Sanchez, F, Salvado, M, Curran, A, Tortola, M, Pozamczer, D, Saumoy, M, Alcaide, F, Martinez-Lacasa, X, Cuchi, E, Sambeat, M, Pomar, V, Coll, P, Miralles, P, Moreno, S, Iribarren, J, Ibarguren, M, Aldamiz, T, Rickenbach, M, Sagette, M, Chapman, A, Dockrell, D, Wilkins, E, Cooke, G, Ainsworth, J, Macallen, D, Dhar, J, Vora, N, Mullaney, S, Kegg, S, Kyselyova, G, Mansfeld M., Skrahina A., Shepherd L., Schultze A., Panteleev A., Miller R., Miro J., Zeltina I., Tetradov S., Furrer H., Kirk O., Grzeszczuk A., Bolokadze N., Matteelli A., Post F., Lundgren J., Mocroft A., Efsen A., Podlekareva D., Losso M. H., Toibaro J. J., Palmero D., Bartoletti B. J., E. Warley, Gear O., Messina O. G., Michans M., Laplume H., David D., Marson C., Scapelatto F. P., Dalessandro D., Lupo S., Costilla Campero G., Herbst M., Remondegui C., Elias C., Karpov I., Vassilenko A., Skrahina E., Skrahin A., Zalutskya A., Kondratenko O., Mitsura V., Bondarenko V., Suetnov O., Paduto D., Dewit S., Payen M. C., Noscoi C., Kabeya K., M. Wolff, Cortes C., Obel N., Kronborg G., Iljna V., Kummik T., Bryand M., Dabis F., Lanchava N., Bablishvili N., Goginashvili L., Mikiashvili L., Mshvidobadze K., Girardi E., Di Biagio A., Apostoli A., Barzoni S., Lapadula G., Purgatorio M., Carbonara S., Rozentale B., Janushkevich I., Caplinskas S., Kancauskienne Z., Caplinskienne I., Crabtree B., Pina A., Madero J. S., Mosqueda J., Villanueva J. A., Bura M., Garlicki A., Inglot M., Knysz B., Kozlowska J., Loster J., Mularska E., Podlasin R., Thompson M., Wiercinska-Drapalo A., Duiculescu D., Rakhmanova A., Yakovlev A., Turkalova A., Vlasova Y., Trotimora T., Borodulina E., Chumanova L., Mashkova Y., Miro J. M., Cayla J. A., Moreno A., Millet J. P., Orcau A., Fina L., del Bano L., Roldan L. L., Romero A., Martinez J. A., Manzardo C., Gonzalez J., Tudo G., Knobel H., Sanchez F., Salvado M., Curran A., Tortola M. T., Pozamczer D., Saumoy M., Alcaide F., Martinez-Lacasa X., Cuchi E., Sambeat M. A., Pomar V., Coll P., Miralles P., Moreno S., Iribarren J. A., Ibarguren M., Aldamiz T., Rickenbach M., Sagette M., Post F. A., Miller R. F., Chapman A., Dockrell D., Wilkins E., Cooke G., Ainsworth J., Macallen D., Dhar J., Vora N., Mullaney S., Kegg S., and Kyselyova G.

Abstract

Objectives: The aim of the study was to investigate the organization and delivery of HIV and tuberculosis (TB) health care and to analyse potential differences between treatment centres in Eastern (EE) and Western Europe (WE). Methods: Thirty-eight European HIV and TB treatment centres participating in the TB:HIV study within EuroCoord completed a survey on health care management for coinfected patients in 2013 (EE: 17 respondents; WE:21; 76% of all TB:HIV centres). Descriptive statistics were obtained for regional comparisons. The reported data on health care strategies were compared with actual clinical practice at patient level via data derived from the TB:HIV study. Results: Respondent centres in EE comprised: Belarus (n=3), Estonia (1), Georgia (1), Latvia (1), Lithuania (1), Poland (4), Romania (1), the Russian Federation (4) and Ukraine (1); those in WE comprised: Belgium (1), Denmark (1), France (1), Italy (7), Spain (2), Switzerland (1) and UK (8). Compared with WE, treatment of HIV and TB in EE are less often located at the same site (47% in EE versus 100% in WE; P<0.001) and less often provided by the same doctors (41% versus 90%, respectively; P=0.002), whereas regular screening of HIV-infected patients for TB (80% versus 40%, respectively; P=0.037) and directly observed treatment (88% versus 20%, respectively; P<0.001) were more common in EE. The reported availability of rifabutin and second- and third-line anti-TB drugs was lower, and opioid substitution therapy (OST) was available at fewer centres in EE compared with WE (53% versus 100%, respectively; P<0.001). Conclusions: Major differences exist between EE and WE in relation to the organization and delivery of health care for HIV/TB-coinfected patients and the availability of anti-TB drugs and OST. Significant discrepancies between reported and actual clinical practices were found in EE.

Published
2015

10. Management of MDR-TB in HIV co-infected patients in Eastern Europe: Results from the TB:HIV study

Author

Efsen, A, Schultze, A, Miller, R, Panteleev, A, Skrahin, A, Podlekareva, D, Miro, J, Girardi, E, Furrer, H, Losso, M, Toibaro, J, Cayla, J, Mocroft, A, Lundgren, J, Post, F, Kirk, O, Karpov, I, Vassilenko, A, Skrahina, A, Klimuk, D, Kondratenko, O, Zalutskaya, A, Bondarenko, V, Mitsura, V, Kozorez, E, Tumash, O, Suetnov, O, Paduto, D, Iljina, V, Kummik, T, Bolokadze, N, Mshvidobadze, K, Lanchava, N, Goginashvili, L, Mikiashvili, L, Bablishvili, N, Rozentale, B, Zeltina, I, Janushkevich, I, Caplinskiene, I, Caplinskas, S, Kancauskiene, Z, Podlasin, R, Wiercinska-Drapalo, A, Thompson, M, Kozlowska, J, Grezesczuk, A, Bura, M, Knysz, B, Inglot, M, Garlicki, A, Loster, J, Tetradov, S, Duiculescu, D, Rakhmanova, A, Panteleeva, O, Yakovlev, A, Kozlov, A, Tyukalova, A, Vlasova, Y, Trofimov, T, Kyselyova, G, Andersen, A, Thorsteinsson, K, Payen, M, Kabeya, K, Necsoi, C, Dabis, F, Bruyand, M, Morlat, P, Dupont, A, Gerard, Y, Bonnal, F, Ceccaldi, J, De Witte, S, Monlun, E, Lataste, P, Chossat, I, Vora, N, Cooke, G, Mullaney, S, Wilkins, E, George, V, Collini, P, Dockrell, D, Campbell, L, Brum, R, Mabonga, E, Saigal, P, Kegg, S, Ainsworth, J, Waters, A, Dhar, J, Mashonganyika, L, Rianda, A, Galati, V, Pinnetti, C, Tommasi, C, Lapadula, G, Di Biagio, A, Parisini, A, Carbonara, S, Angarano, G, Purgatorio, M, Matteelli, A, Apostoli, A, Macias, L, Warley, E, Tavella, S, Garcia Messina, O, Gear, O, Laplume, H, Marson, C, Contarelia, J, Michaan, M, Scapellato, P, Alessandro, D, Bartoletti, B, Palmero, D, Elias, C, Cortes, C, Crabtree, B, Mosqueda Gomez, J, Villanueva, A, Gonzalez Hernandez, L, Efsen, AMW, Miller, RF, Podlekareva, DN, Miro, JM, Losso, MH, Cayla, JA, Lundgren, JD, Post, FA, Andersen, AB, Payen, MC, Macias, LM, Alessandro, DD, Mosqueda Gomez, JL, Gonzalez Hernandez, LA, Efsen, A, Schultze, A, Miller, R, Panteleev, A, Skrahin, A, Podlekareva, D, Miro, J, Girardi, E, Furrer, H, Losso, M, Toibaro, J, Cayla, J, Mocroft, A, Lundgren, J, Post, F, Kirk, O, Karpov, I, Vassilenko, A, Skrahina, A, Klimuk, D, Kondratenko, O, Zalutskaya, A, Bondarenko, V, Mitsura, V, Kozorez, E, Tumash, O, Suetnov, O, Paduto, D, Iljina, V, Kummik, T, Bolokadze, N, Mshvidobadze, K, Lanchava, N, Goginashvili, L, Mikiashvili, L, Bablishvili, N, Rozentale, B, Zeltina, I, Janushkevich, I, Caplinskiene, I, Caplinskas, S, Kancauskiene, Z, Podlasin, R, Wiercinska-Drapalo, A, Thompson, M, Kozlowska, J, Grezesczuk, A, Bura, M, Knysz, B, Inglot, M, Garlicki, A, Loster, J, Tetradov, S, Duiculescu, D, Rakhmanova, A, Panteleeva, O, Yakovlev, A, Kozlov, A, Tyukalova, A, Vlasova, Y, Trofimov, T, Kyselyova, G, Andersen, A, Thorsteinsson, K, Payen, M, Kabeya, K, Necsoi, C, Dabis, F, Bruyand, M, Morlat, P, Dupont, A, Gerard, Y, Bonnal, F, Ceccaldi, J, De Witte, S, Monlun, E, Lataste, P, Chossat, I, Vora, N, Cooke, G, Mullaney, S, Wilkins, E, George, V, Collini, P, Dockrell, D, Campbell, L, Brum, R, Mabonga, E, Saigal, P, Kegg, S, Ainsworth, J, Waters, A, Dhar, J, Mashonganyika, L, Rianda, A, Galati, V, Pinnetti, C, Tommasi, C, Lapadula, G, Di Biagio, A, Parisini, A, Carbonara, S, Angarano, G, Purgatorio, M, Matteelli, A, Apostoli, A, Macias, L, Warley, E, Tavella, S, Garcia Messina, O, Gear, O, Laplume, H, Marson, C, Contarelia, J, Michaan, M, Scapellato, P, Alessandro, D, Bartoletti, B, Palmero, D, Elias, C, Cortes, C, Crabtree, B, Mosqueda Gomez, J, Villanueva, A, Gonzalez Hernandez, L, Efsen, AMW, Miller, RF, Podlekareva, DN, Miro, JM, Losso, MH, Cayla, JA, Lundgren, JD, Post, FA, Andersen, AB, Payen, MC, Macias, LM, Alessandro, DD, Mosqueda Gomez, JL, and Gonzalez Hernandez, LA

Abstract

Objectives Mortality among HIV patients with tuberculosis (TB) remains high in Eastern Europe (EE), but details of TB and HIV management remain scarce. Methods In this prospective study, we describe the TB treatment regimens of patients with multi-drug resistant (MDR) TB and use of antiretroviral therapy (ART). Results A total of 105 HIV-positive patients had MDR-TB (including 33 with extensive drug resistance) and 130 pan-susceptible TB. Adequate initial TB treatment was provided for 8% of patients with MDR-TB compared with 80% of those with pan-susceptible TB. By twelve months, an estimated 57.3% (95%CI 41.5–74.1) of MDR-TB patients had started adequate treatment. While 67% received ART, HIV-RNA suppression was demonstrated in only 23%. Conclusions Our results show that internationally recommended MDR-TB treatment regimens were infrequently used and that ART use and viral suppression was well below the target of 90%, reflecting the challenging patient population and the environment in which health care is provided. Urgent improvement of management of patients with TB/HIV in EE, in particular for those with MDR-TB, is needed and includes widespread access to rapid TB diagnostics, better access to and use of second-line TB drugs, timely ART initiation with viral load monitoring, and integration of TB/HIV care.

Published
2018

11. Management of MDR-TB in HIV co-infected patients in Eastern Europe: Results from the TB:HIV study

Author

Efsen, A.M.W., primary, Schultze, A., additional, Miller, R.F., additional, Panteleev, A., additional, Skrahin, A., additional, Podlekareva, D.N., additional, Miro, J.M., additional, Girardi, E., additional, Furrer, H., additional, Losso, M.H., additional, Toibaro, J., additional, Caylà, J.A., additional, Mocroft, A., additional, Lundgren, J.D., additional, Post, F.A., additional, Kirk, O., additional, Karpov, I., additional, Vassilenko, A., additional, Skrahina, A., additional, Klimuk, D., additional, Kondratenko, O., additional, Zalutskaya, A., additional, Bondarenko, V., additional, Mitsura, V., additional, Kozorez, E., additional, Tumash, O., additional, Suetnov, O., additional, Paduto, D., additional, Iljina, V., additional, Kummik, T., additional, Bolokadze, N., additional, Mshvidobadze, K., additional, Lanchava, N., additional, Goginashvili, L., additional, Mikiashvili, L., additional, Bablishvili, N., additional, Rozentale, B., additional, Zeltina, I., additional, Janushkevich, I., additional, Caplinskiene, I., additional, Caplinskas, S., additional, Kancauskiene, Z., additional, Podlasin, R., additional, Wiercinska-Drapalo, A., additional, Thompson, M., additional, Kozlowska, J., additional, Grezesczuk, A., additional, Bura, M., additional, Knysz, B., additional, Inglot, M., additional, Garlicki, A., additional, Loster, J., additional, Tetradov, S., additional, Duiculescu, D., additional, Rakhmanova, A., additional, Panteleeva, O., additional, Yakovlev, A., additional, Kozlov, A., additional, Tyukalova, A., additional, Vlasova, Y., additional, Trofimov, T., additional, Kyselyova, G., additional, Andersen, A.B., additional, Thorsteinsson, K., additional, Payen, M.C., additional, Kabeya, K., additional, Necsoi, C., additional, Dabis, F., additional, Bruyand, M., additional, Morlat, P., additional, Dupont, A., additional, Gerard, Y., additional, Bonnal, F., additional, Ceccaldi, J., additional, De Witte, S., additional, Monlun, E., additional, Lataste, P., additional, Chossat, I., additional, Miller, R., additional, Vora, N., additional, Cooke, G., additional, Mullaney, S., additional, Wilkins, E., additional, George, V., additional, Collini, P., additional, Dockrell, D., additional, Post, F., additional, Campbell, L., additional, Brum, R., additional, Mabonga, E., additional, Saigal, P., additional, Kegg, S., additional, Ainsworth, J., additional, Waters, A., additional, Dhar, J., additional, Mashonganyika, L., additional, Rianda, A., additional, Galati, V., additional, Pinnetti, C., additional, Tommasi, C., additional, Lapadula, G., additional, Di Biagio, A., additional, Parisini, A., additional, Carbonara, S., additional, Angarano, G., additional, Purgatorio, M., additional, Matteelli, A., additional, Apostoli, A., additional, Macias, L. Moreno, additional, Warley, E., additional, Tavella, S., additional, Garcia Messina, O., additional, Gear, O., additional, Laplume, H., additional, Marson, C., additional, Contarelia, J., additional, Michaan, M., additional, Scapellato, P., additional, Alessandro, D.D., additional, Bartoletti, B., additional, Palmero, D., additional, Elias, C., additional, Cortes, C., additional, Crabtree, B., additional, Mosqueda Gomez, J.L., additional, Villanueva, A., additional, and Gonzalez Hernandez, L.A., additional

Published
2018
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12. Tuberculosis-related mortality in people living with HIV in Europe and Latin America: An international cohort study

Author

Podlekareva Daria, N, Efsen Anne Marie, W, Schultze, A, Post Frank, A, Skrahina Alena, M, Panteleev, A, Furrer, H, Miller Robert, F, Losso, M. H, Toibaro, J, Miro Jose, M, Vassilenko, A, Girardi, Enrico, Bruyand, M, Obel, N, Lundgren Jens, D, Mocroft, A, Kirk, O, Karpov, I, Skrahina, A, Klimuk, D, Skrahin, A, Kondratenko, O, Zalutskaya, A, Bondarenko, V, Mitsura, V, Kozorez, E, Tumash, O, Suetnov, O, Paduto, D, Iljina, V, Kummik, T, Bolokadze, N, Mshvidobadze, K, Lanchava, N, Goginashvili, L, Mikiashvili, L, Bablishvili, N, Rozentale, B, Zeltina, I, Janushkevich, I, Caplinskiene, I, Caplinskas, S, Kancauskiene, Z, Podlasin, R, Wiercinska Drapalo, A, Thompson, M, Kozlowska, J, Grezesczuk, A, Bura, M, Knysz, B, Inglot, M, Garlicki, A, Loster, J, Duiculescu, D, Tetradov, S, Rakhmanova, A, Panteleeva, O, Yakovlev, A, Kozlov, A, Tyukalova, A, Vlasova, Y, Trofimov, T, Kyselyova, G, Thorsteinsson, K, Payen, Mc, Kabeya, K, Necsoi, C, Dabis, F, Morlat, P, Dupont, A, Gerard, Y, Bonnal, F, Ceccaldi, J, De Witte, S, Monlun, E, Lataste, P, Chossat, I, Sagette, M, Rickenbach, M, Elzi, L, Battegay, M, Sculier, D, Calmy, A, Cavassini, M, Bruno, A, Bernasconi, E, Hoffmann, M, Vernazza, P, Fehr, J, Weber, R, Aubert, V, Böni, J, Bucher, Hc, Burton Jeangros, C, Dollenmaier, G, Egger, M, Fellay, J, Fux, Ca, Gorgievski, M, Günthard, H, Haerry, D, Hasse, B, Hirsch, Hh, Hösli, I, Kahlert, C, Kaiser, L, Keiser, O, Klimkait, T, Kouyos, R, Kovari, H, Ledergerber, B, Martinetti, G, Martinez de Tejada, B, Metzner, K, Müller, N, Nadal, D, Nicca, D, Pantaleo, G, Rauch, A, Regenass, S, Rudin, C, Schöni Affolter, F, Schmid, P, Schüpbach, J, Speck, R, Tarr, P, Telenti, A, Trkola, A, Yerly, S, Miller, Rf, Vora, N, Cooke, G, Mullaney, S, Wilkins, E, George, V, Collini, P, Dockrell, D, Post, F, Campbell, L, Brum, R, Mabonga, E, Saigal, P, Kegg, S, Ainsworth, J, Waters, A, Dhar, J, Mashonganyika, L, Girardi, E, Rianda, A, Galati, V, Pinnetti, C, Tommasi, C, Lapadula, G, Di Biagio, A, Parisini, A, Carbonara, S, Angarano, G, Purgatorio, M, Matteelli, Alberto, Apostoli, A, Miro, Jm, Manzardo, C, Ligero, C, Gonzalez, J, Martinez Martinez, Ja, Sanchez, F, Knobel, H, Salvadó, M, Lopez Colomes, Jl, Martínez Lacasa, X, Cuchí, E, Falcó, V, Curran, A, Tortola, Mt, Ocaña, I, Vidal, R, Sambeat, Ma, Pomar, V, Coll, P, Pozamczer, D, Saumoy, M, Alcaide, F, Caylà, J, Moreno, A, Millet, Jp, Orcau, A, Fina, L, Romero, A, Roldan, Ll, Iribarren, Ja, Ibarguren, M, Moreno, S, González, A, Miralles, P, Aldámiz Echevarría, T, Losso, M, Gambardella, L, Macias, L, Warley, E, Tavella, S, Messina, O, Gear, O, Laplume, H, Marson, C, Contarelia, J, Michaan, M, Scapellato, P, Alessandro, D, Bartoletti, B, Palmero, D, Elias, C, Cortes, C, Crabtree, B, Gomez, Jl, Hernandez, La, and Badial, F.

Subjects
Adult, Male, 0301 basic medicine, Pediatrics, medicine.medical_specialty, Latin Americans, Tuberculosis, Anti-HIV Agents, Epidemiology, 030106 microbiology, Population, Infectious Diseases, Immunology, Virology, Antitubercular Agents, HIV Infections, Cohort Studies, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Tuberculosis, Multidrug-Resistant, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Young adult, Epidemics, education, Prospective cohort study, education.field_of_study, AIDS-Related Opportunistic Infections, business.industry, Mortality rate, Middle Aged, medicine.disease, Europe, Latin America, Female, business, Developed country, Demography, Cohort study
Abstract

Management of tuberculosis in patients with HIV in eastern Europe is complicated by the high prevalence of multidrug-resistant tuberculosis, low rates of drug susceptibility testing, and poor access to antiretroviral therapy (ART). We report 1 year mortality estimates from a multiregional (eastern Europe, western Europe, and Latin America) prospective cohort study: the TB:HIV study.Consecutive HIV-positive patients aged 16 years or older with a diagnosis of tuberculosis between Jan 1, 2011, and Dec 31, 2013, were enrolled from 62 HIV and tuberculosis clinics in 19 countries in eastern Europe, western Europe, and Latin America. The primary endpoint was death within 12 months after starting tuberculosis treatment; all deaths were classified according to whether or not they were tuberculosis related. Follow-up was either until death, the final visit, or 12 months after baseline, whichever occurred first. Risk factors for all-cause and tuberculosis-related deaths were assessed using Kaplan-Meier estimates and Cox models.Of 1406 patients (834 in eastern Europe, 317 in western Europe, and 255 in Latin America), 264 (19%) died within 12 months. 188 (71%) of these deaths were tuberculosis related. The probability of all-cause death was 29% (95% CI 26-32) in eastern Europe, 4% (3-7) in western Europe, and 11% (8-16) in Latin America (p0·0001) and the corresponding probabilities of tuberculosis-related death were 23% (20-26), 1% (0-3), and 4% (2-8), respectively (p0·0001). Patients receiving care outside eastern Europe had a 77% decreased risk of death: adjusted hazard ratio (aHR) 0·23 (95% CI 0·16-0·31). In eastern Europe, compared with patients who started a regimen with at least three active antituberculosis drugs, those who started fewer than three active antituberculosis drugs were at a higher risk of tuberculosis-related death (aHR 3·17; 95% CI 1·83-5·49) as were those who did not have baseline drug-susceptibility tests (2·24; 1·31-3·83). Other prognostic factors for increased tuberculosis-related mortality were disseminated tuberculosis and a low CD4 cell count. 18% of patients were receiving ART at tuberculosis diagnosis in eastern Europe compared with 44% in western Europe and 39% in Latin America (p0·0001); 12 months later the proportions were 67% in eastern Europe, 92% in western Europe, and 85% in Latin America (p0·0001).Patients with HIV and tuberculosis in eastern Europe have a risk of death nearly four-times higher than that in patients from western Europe and Latin America. This increased mortality rate is associated with modifiable risk factors such as lack of drug susceptibility testing and suboptimal initial antituberculosis treatment in settings with a high prevalence of drug resistance. Urgent action is needed to improve tuberculosis care for patients living with HIV in eastern Europe.EU Seventh Framework Programme.

Published
2016

14. Cavitary lung lesions and quality of life after TB.

Author

Smirnova N, Bryan CS, Salindri AD, Avaliani T, Goginashvili L, Gujabidze M, Kempker RR, Kornfeld H, Auld SC, Vashakidze S, Avaliani Z, Kavalieratos D, Kipiani M, and Magee MJ

Subjects
Humans, Male, Lung diagnostic imaging, Female, Middle Aged, Adult, Quality of Life, Tuberculosis, Pulmonary drug therapy
Published
2024
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15. High utility of contact investigation for latent and active tuberculosis case detection among the contacts: a retrospective cohort study in Tbilisi, Georgia, 2010-2011.

Author

Chakhaia T, Magee MJ, Kempker RR, Gegia M, Goginashvili L, Nanava U, and Blumberg HM

Subjects
Adolescent, Adult, Aged, Child, Child, Preschool, Cohort Studies, Female, Follow-Up Studies, Georgia epidemiology, Humans, Infant, Infant, Newborn, Male, Middle Aged, Prevalence, Retrospective Studies, Risk Factors, Young Adult, Contact Tracing statistics & numerical data, Latent Tuberculosis epidemiology
Abstract

Setting: The study was conducted at the National Center for Tuberculosis and Lung Diseases (NCTBLD) in Tbilisi, Georgia., Objective: To assess the utility of contact investigation for tuberculosis (TB) case detection. We also assessed the prevalence and risk factors for active TB disease and latent TB infection (LTBI) among contacts of active pulmonary TB cases., Design: A retrospective cohort study was conducted among the contacts of active pulmonary TB cases registered in 2010-2011 at the NCTBLD in Tbilisi, Georgia. Contacts of active TB patients were investigated according to an "invitation model": they were referred to the NCTBLD by the index case; were queried about clinical symptoms suggestive of active TB disease; tuberculin skin testing and chest radiographs were performed. Demographic, laboratory, and clinical data of TB patients and their contacts were abstracted from existing records up to February 2013., Results: 869 contacts of 396 index cases were enrolled in the study; a median of 2 contacts were referred per index case. Among the 869 contacts, 47 (5.4%) were found to have or developed active TB disease: 30 (63.8%) were diagnosed with TB during the baseline period (co-prevalent cases) and 17 (36.2%) developed active TB disease during the follow-up period (mean follow up of 21 months) (incident TB cases). The incidence rate of active TB disease among contacts was 1126.0 per 100,000 person years (95% CI 655.7-1802.0 per 100,000 person-years). Among the 402 contacts who had a tuberculin skin test (TST) performed, 52.7% (95% CI 47.7-57.7%) had LTBI., Conclusions: A high prevalence of LTBI and active TB disease was found among the contacts of TB cases in Tbilisi, Georgia. Our findings demonstrated that an "invitation" model of contact investigation was an effective method of case detection. Therefore, contact investigation should be scaled up in Georgia.

Published
2014
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16. Monitoring therapeutic efficacy by real-time detection of Mycobacterium tuberculosis mRNA in sputum.

Author

Mdivani N, Li H, Akhalaia M, Gegia M, Goginashvili L, Kernodle DS, Khechinashvili G, and Tang YW

Subjects
Adult, False Positive Reactions, Female, Humans, Male, Mycobacterium tuberculosis genetics, RNA, Bacterial genetics, RNA, Messenger genetics, Time Factors, Antitubercular Agents therapeutic use, Mycobacterium tuberculosis drug effects, RNA, Bacterial analysis, RNA, Messenger analysis, Reverse Transcriptase Polymerase Chain Reaction methods, Sputum microbiology, Tuberculosis, Pulmonary drug therapy, Tuberculosis, Pulmonary microbiology
Abstract

Background: Current laboratory methods for monitoring the response to therapy for tuberculosis (TB) rely on mycobacterial culture. Their clinical usefulness is therefore limited by the slow growth rate of Mycobacterium tuberculosis. Rapid methods to reliably quantify the response to anti-TB drugs are desirable., Methods: We developed 2 real-time PCR assays that use hydrolysis probes to target DNA of the IS6110 insertion element and mRNA for antigen 85B. The nucleic acids are extracted directly from concentrated sputum samples decontaminated with sodium hydroxide and N-acetyl-L-cysteine. We prospectively compared these assays with results obtained by sputum mycobacterial culture for patients receiving anti-TB therapy., Results: Sixty-five patients with newly diagnosed TB and receiving a standardized first-line anti-TB drug regimen were evaluated at week 2 and at months 1, 2, and 4 after therapy initiation. Both the DNA PCR assay (98.5% positive) and the mRNA reverse-transcription PCR (RT-PCR) assay (95.4% positive) were better than standard Ziehl-Neelsen staining techniques (83.1%) for detecting M. tuberculosis in culture-positive sputum samples. The overall agreement between culture and mRNA RT-PCR results for all 286 sputum samples was 87.1%, and compared with culture, the mRNA RT-PCR assay's diagnostic sensitivity and specificity were 85.2% and 88.6%, respectively. For monitoring efficacy of therapy, mRNA RT-PCR results paralleled those of culture at the follow-up time points., Conclusions: The continued presence of viable M. tuberculosis according to culture and results obtained by RT-PCR analysis of antigen 85B mRNA correlated clinically with resistance to anti-TB drugs, whereas the DNA PCR assay showed a high false-positive rate. This mRNA RT-PCR assay may allow rapid monitoring of the response to anti-TB therapy.

Published
2009
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17. [The placental histo- and ultrastructure peculiarities during the cytomegalovirus infection in pregnant].

Author

Pkhakadze ID, Kvachadze TI, Turava NG, Goginashvili LE, and Tsagareli ZG

Subjects
Enzyme-Linked Immunosorbent Assay, Female, Humans, Pregnancy, Cytomegalovirus Infections diagnosis, Cytomegalovirus Infections immunology, Immunoglobulin G immunology, Immunoglobulin M immunology, Placenta immunology, Placenta ultrastructure
Abstract

Object of the investigation - estimation of changes of the feto-placental complex and syncytiotrophoblaston based on the placental morphology and the activity of the antiviral antibodies in expectant mothers. The work is based on findings from 50 expectant mothers with cytomegalovirus (CMV) infection - 43 with reactivation of the latent infection according to the data of high avid IgG (86%) and 7 with primary active CMV infection according the level of the low avid IgG (14%). 20 healthy expectant mothers were included in the control group. It was shown that the active primary and reactivated CMV infection accompanied by the drawing in pathologic process the chorion structures in a productive inflammation - chorionamnionis and choriovillusitis manner, which testify to drawing the fetus immune system in reciprocal reaction with subsequent intrauterine growth retardation.

Published
2007

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