The Euroguidelines in Central and

Eastern Europe Conference (ECEE) :

a summary

Justyna Kowalska Hospital For Infectious Diseases, Medical

University Of Warsaw

over 50 participants from 16 countries Albania, Armenia, Belarus, Croatia, Czech Republic, Estonia, Georgia, Hungary, Lithuania, Moldova, Poland, Romania, Russia, Serbia, Slovakia, Turkey

MEETING FORMAT

• Key areas of Euroguidelines were presented by invited speakers

• cART, Co-morbidities, Standards of care, OIs

• Country representatives presented national data

• epidemiology, national strategy, standards of care

• Topics specific for ECE presented by lecturers from the region

• IDU, children&adolescents, women

• Networking & discussion led by facilitators

• Monitoring the epidemic, monitoring cART efficacy and safety,

howt to start, resistance, HIV/HCV co-infection

DISCUSSION AND NETWORKING

DISCUSSION AND NETWORKING

MONITORING THE EPIDEMIC • major diversities in epidemics between countries

• surviellance systems based on anonymous reporting (50%)

• current numer of PLWH not captured by surviellance

• info on transmission mode often missing

• little or no data on linkage and suppression rates

• only AIDS deaths reported

• data from regiona/national cohorts giving better insight (publication policies)

STARTING AND MONITORING CART • cART available, but CD4 treshold still holds

• limitations in first line choice

• not all arv available, delayed registration (TB, HCV, co-morbidities)

• in most participating countries there is access to laboratory capacity and well trained staff (CD4, VL, tropism, HLA, resistance)

• although some countries experience problems with continuity of supplies for regular assessments (high costs!)

• resistance testing for naive rarely a routine (spread 2008-2010 TDR 8.3%)

MODELS OF CARE

• sustainability of treatment and care is an issue

• HIV physicians are often taking a role of GP

• HIV care centralization (Croatia)

• struggling for adequate financing system (KAOS in Poland)

• addressing stigma is crucial

ECE SPECIFICS

• Significant shifts in epidemic patterns ( eg. IDU to MSM)

• Drug Abuse (opioids >>>legal highs, ethnobotanicals)

• Adolescents

•Women

• TB and poverty

GUIDELINES USED IN ECEU

T0PICS FOR NEXT ECEE MEETINGS

•More countries to be included

• Young investigators in the spot

• Cascade of Care both 90-90-90 and 90$-90$-90$

• Cascade of Care both HIV and HCV

• Co-morbidities and models of care

•…

THANK YOU AND SEE YOU IN WARSAW AGAIN EACS