Current Trends of HIV Infection in the Russian Federation

Ogarkova, Daria; Antonova, Anastasiia; Kuznetsova, Anna; Adgamov, Ruslan; Pochtovyi, Andrei; Kleimenov, Denis; Tsyganova, Elena; Gushchin, Vladimir; Gintsburg, Aleksandr; Mazus, Aleksei

doi:10.3390/v15112156

Cited by 5 publications

(2 citation statements)

References 20 publications

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“…The World Health Organization reported that in 2021, HIV incidence was six times higher in Russia than in the rest of Europe [1]. HIV prevalence nationally was estimated at 0.68% in 2022 [2]. Uptake of antiretroviral therapy (ART) is reported to have increased sharply since 2018, to as high as 93% of people with HIV (PWH) who are diagnosed and recorded in the Federal HIV Register [2], though with a good deal of regional variation in coverage.…”

Section: Introductionmentioning

confidence: 99%

“…HIV prevalence nationally was estimated at 0.68% in 2022 [2]. Uptake of antiretroviral therapy (ART) is reported to have increased sharply since 2018, to as high as 93% of people with HIV (PWH) who are diagnosed and recorded in the Federal HIV Register [2], though with a good deal of regional variation in coverage. Injection drug use remains a major risk factor for HIV acquisition in Russia [3,4], and the proportion of people who inject drugs who are registered in the Federal HIV Register is likely relatively low.…”

Section: Introductionmentioning

confidence: 99%

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Comparative costs and potential affordability of a multifaceted intervention to improve treatment outcomes among people with HIV who inject drugs in Russia: economic evaluation of the LINC‐II randomized controlled trial

Rosen,

Blokhina,

Truong

et al. 2024

J Int AIDS Soc.

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IntroductionThe LINC‐II randomized controlled trial in St. Petersburg, Russia for HIV‐positive adults who inject drugs found that a multi‐component intervention including initiation of antiretroviral therapy (ART) during admission to an addiction hospital, strengths‐based case management and naltrexone significantly increased 12‐month HIV viral suppression and ART retention. We conducted a comparative cost analysis to determine if the 12‐month cost of the intervention is affordable within the current Russian health system.MethodsWe used LINC‐II trial records and questionnaire responses to calculate the resources utilized by each participant in the study, including inpatient days, medications, laboratory tests, outpatient consultations, case manager interactions and opioid medication treatment. Quantities of resources utilized were multiplied by unit costs for each resource estimated from the service fee or price lists used by the study facilities for each specific service delivered. We report the average cost/study primary (viral suppression at 12 months) or secondary (retention in care at 12 months) outcome/participant in 2021 USD and compare costs between study arms.ResultsThe trial enrolled 225 participants (111 intervention, 114 control) between September 2018 and December 2020. Viral suppression, non‐suppression and missing suppression results were 28% and 14%, 49% and 37%, and 31% and 41% for the control and intervention arms, respectively. Retention results were 35% and 51% for the control and intervention arms, respectively. The average cost per study participant was $2714 in the control arm and $4342 in the intervention arm. The average cost per participant virally suppressed at 12 months was $3662 (control) and $6355 (intervention). The average cost per participant retained at 12 months was $4050 (control) and $5448 (intervention). For those retained, the cost difference between the arms was comprised of opioid treatment (35%), case management (31%), outpatient visits (18%) and additional days of ART (12%).ConclusionsThe LINC‐II intervention increased the cost of care for HIV‐positive people who inject drugs in Russia significantly, but some components of the intervention, particularly earlier initiation of ART and case management, may be justifiable due to their success in reaching a challenging subgroup of the population in need.Clinical Trial NumberNCT03290391

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparative costs and potential affordability of a multifaceted intervention to improve treatment outcomes among people with HIV who inject drugs in Russia: economic evaluation of the LINC‐II randomized controlled trial

Rosen,

Blokhina,

Truong

et al. 2024

J Int AIDS Soc.

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Mortality and comorbidities in a Nationwide cohort of HIV-infected adults: comparison to a matched non-HIV adults’ cohort, France, 2006–18

Vallée,

Majerholc,

Zucman

et al. 2024

European Journal of Public Health

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Background Human immunodeficiency virus (HIV) remains a significant cause of morbidity and mortality worldwide. The aim of this study was to describe the mortality rate and associated comorbidities in a nationwide population-based cohort of persons living with HIV (PLWHIV) and to compare it with mortality in an age and gender-matched cohort of non-HIV individuals in France. Methods Using data from the French national health data system, we identified and included 173 712 PLWHIV (66.5% men) and 173 712 non-HIV participants (66.5% men) matched for age and gender. PLHIV were identified based on ICD-10 HIV diagnoses, HIV-specific laboratory tests, and/or prescriptions for antiretroviral therapy specific to HIV. Hazard ratios (HRs) of mortality were assessed using multiple Cox regression models. Results During the 13 years of follow-up (2006–18), we observed 20 018 deaths among PLWHIV compared with 6262 deaths among non-HIV participants (11.52% vs. 3.60%, P < 0.001). The over-mortality of PLWHIV was expressed by univariable HR = 2.135 (2.072–2.199), which remained significant after adjustment for region, Complementary Universal Health Insurance and AME, with multivariable HR = 2.182 (2.118–2.248). The results remained significant after adjusting for comorbidities, including infectious diseases [HR = 1.587 (1.538–1.638)]. Notably, PLWHIV were more importantly associated with mortality in women [HR = 2.966 (2.767–3.180)], compared in men [HR = 1.961 (1.898–2.027)]. Conclusion Although the life expectancy of PLWHIV has globally increased, the causes of death should be prioritized in prevention policies and care management. Gender-specific policies should be highlighted, as we observed a higher impact of HIV mortality in women.

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HIV-infection in the Russian Federation: current diagnostic trends

Adgamov,

Antonova,

Ogarkova

et al. 2024

VIČ-infekc. immunosupr.

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The aim of the study: to analyse diagnostic trends of HIV-infection in the Russian Federation in the period 2017–2022. Materials and methods. The study used data obtained from reports from the Federal Register of persons infected with the human immunodeficiency virus (FRHIV). The circumstances in HIV diagnosis and clinical and epidemiological characteristics of newly diagnosed patients, including CD4+ T-lymphocyte counts, were analysed. A likely time window between presumed infection and confirmation of HIV diagnosis was also determined. Categorical data evaluated in the study were presented as proportions and caparisoned using the chi-square test (χ2). In case of multiple comparisons, the Bonferroni correction for multiplicity was used. Quantitative data were tested for normality using the Kolmogorov-Smirnov criterion. In most cases, nonparametric characteristics of distributions — median and interquartile range — were applied, as well as the Mann-Whitney criteria for comparison of two independent groups and the Kraskell-Wallis criteria for comparison more than two groups, followed by pair wise comparisons using the Mann-Whitney criterion with Bonferroni multiplicity correction. A p-value<0.05 was considered statistically significant. Data analysis and graphical visualization was performed using the statistical software R version 4.1.1 and its libraries.Results and discussion. The results showed an increase in HIV detection through voluntary testing, preventive medical examination, and clinical indications. The proportion of injecting drug users (IDUs) decreased over time, while the involvement of women in the epidemic process and heterosexual transmission increased. Additionally, there was an increase in the proportion of patients aged 35 years and older. The analysis of CD4-cell counts revealed significant differences among gender and age subgroups. Women had higher absolute CD4-lymphocyte counts throughout the follow-up period. Patients aged 0–14 years had the highest proportion of CD4-lymphocytes over 500 cells/μL, while patients over 50 years old had the highest proportion of CD4-lymphocytes less than 200 cells/μL. Men who have sex with men and people infected through mother-to-child transmission had the highest mean baseline CD4-cell counts. IDUs and heterosexuals had a statistically significant decrease in CD4-cell counts over the follow-up period and also had the longest median time from infection to disease detection — 24 and 20 months, respectively.Conclusion: Thus, this study helps identify the most significant risk groups of HIV-infected individuals in Russia at present.

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Current Trends of HIV Infection in the Russian Federation

Cited by 5 publications

References 20 publications

Comparative costs and potential affordability of a multifaceted intervention to improve treatment outcomes among people with HIV who inject drugs in Russia: economic evaluation of the LINC‐II randomized controlled trial

Comparative costs and potential affordability of a multifaceted intervention to improve treatment outcomes among people with HIV who inject drugs in Russia: economic evaluation of the LINC‐II randomized controlled trial

Mortality and comorbidities in a Nationwide cohort of HIV-infected adults: comparison to a matched non-HIV adults’ cohort, France, 2006–18

HIV-infection in the Russian Federation: current diagnostic trends

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