Status of HIV and comorbidities in refugees with HIV from Ukraine

Gerrit Ahrenstorf; Alexandra Dopfer-Jablonka; Oana Joean; Christine Knuth; Marc Silchmueller; Thea Thiele; Felix C Ringshausen; Hortense Slevogt; Torsten Witte; Georg M N Behrens

doi:10.1111/hiv.13597

Status of HIV and comorbidities in refugees with HIV from Ukraine

HIV Med. 2024 Apr;25(4):479-483. doi: 10.1111/hiv.13597. Epub 2023 Dec 3.

Authors

Gerrit Ahrenstorf¹, Alexandra Dopfer-Jablonka^{1

2}, Oana Joean³, Christine Knuth¹, Marc Silchmueller¹, Thea Thiele¹, Felix C Ringshausen^{3

4}, Hortense Slevogt^{3

5}, Torsten Witte^{1

6}, Georg M N Behrens^{1

2

5}

Affiliations

¹ Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany.
² German Centre for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Hannover, Germany.
³ Department of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Hannover, Germany.
⁴ Biomedical Research in End-stage and Obstructive Lung Disease (BREATH), Deutsches Zentrum für Lungenforschung (DZL), Hannover, Germany.
⁵ Center for Individualised Infection Medicine, Hannover, Germany.
⁶ Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Hannover, Germany.

PMID: 38043508
DOI: 10.1111/hiv.13597

Abstract

Purpose: To describe the clinical characteristics of refugees with HIV from Ukraine that seek continuation of medical care in Germany.

Methods: Fourty-six refugees with HIV that had left Ukraine between 24 February and 30 December 2022 were examined. Information on patients' history was obtained using a standardized questionnaire for clinical care. Interviews were conducted in Russian during their first clinical presentation.

Results: Fourty-six persons (41 females and 5 males) were included and their mean age was 39.6 (±8.4) years. The mean time since HIV diagnosis was 8.0 (median, IQR 7.15) years and 70.3% of participants currently received tenfofovir-DF, lamividine and dolutegravir. Most refugees had an undetectable HIV viral load and their current mean CD4 T cell count was 702 (SD ± 289) per μL. Serology revealed previous hepatitis B infection in 50.4% without evidence for replication, with undetectable anti-hepatitis B surface antigen in the remaining refugees. Antibodies against hepatitis C were present in 23 refugees (50%), but only 10 patients had been diagnosed with hepatitis C previously. Five refugees had undergone successful antiviral treatment for hepatitis C. Detectable HCV-RNA was evident in nine patients (19.6%). Sixteen (38.6%) refugees had a positive tuberculosis (TB) interferon gamma release assay, and four were on TB treatment for previously diagnosed infection. One had been diagnosed with multidrug-resistant (MDR) TB, two with pre-extensively drug-resistant (pre-XDR) TB and two with XDR TB and were treated with combinations of second-line and novel agents according to WHO guidelines.

Conclusions: Based on this preliminary analysis of a not fully representative cohort, refugees with HIV from Ukraine were young, mostly healthy females highly adherent to antiretroviral therapy. The rate of transmittable co-infections urges early diagnostic evaluation and treatment.

Keywords: HIV infection; Ukraine; refugees; tuberculosis; viral hepatitis.

MeSH terms

Adult
Antitubercular Agents / therapeutic use
Female
HIV Infections* / diagnosis
HIV Infections* / drug therapy
HIV Infections* / epidemiology
Hepacivirus
Hepatitis C* / drug therapy
Humans
Male
Refugees*
Tuberculosis* / drug therapy
Tuberculosis, Multidrug-Resistant* / drug therapy
Ukraine / epidemiology

Substances

Antitubercular Agents