OBJECTIVES: The aim of this survey was to describe the current status of HIV care in the countries of Central and Eastern Europe and to investigate how close the region is to achieving the UNAIDS 2020 target of 90-90-90. METHODS: In 2014, data were collected from 24 Central and Eastern European countries using a 38-item questionnaire. RESULTS: All countries reported mandatory screening of blood and organ donors for HIV. Other groups subjected to targeted screening included people who inject drugs (PWID) (15/24, 62.5%), men who have sex with men (MSM) (14/24, 58.3%), and sex workers (12/24, 50.0%). Only 14 of the 24 countries (58.3%) screened pregnant women. The percentages of late presentation and advanced disease were 40.3% (range 14-80%) and 25.4% (range 9-50%), respectively. There was no difference between countries categorized by income or by region in terms of the percentages of persons presenting late or with advanced disease. The availability of newer antiretroviral drugs (rilpivirine, etravirine, darunavir, maraviroc, raltegravir, dolutegravir) tended to be significantly better with a higher country income status. Ten countries reported initiating antiretroviral therapy (ART) regardless of CD4+ T cell count (41.7%), five countries (20.8%) used the threshold of <500 cells/μl, and nine countries (37.5%) used the threshold of <350cells/μl. Initiation of ART regardless of the CD4+ T cell count was significantly more common among high-income countries than among upper-middle-income and lower-middle-income countries (100% vs. 27.3% and 0%, respectively; p=0.001). Drugs were provided free of charge in all countries and mostly provided by governments. There were significant discrepancies between countries regarding the follow-up of people living with HIV. CONCLUSIONS: There are major disparities in the provision of HIV care among sub-regions in Europe, which should be addressed. More attention in terms of funding, knowledge and experience sharing, and capacity building is required for the resource-limited settings of Central and Eastern Europe. The exact needs should be defined and services scaled up in order to achieve a standard level of care and provide an adequate and sustainable response to the HIV epidemic in this region.
- MeSH
- HIV infekce farmakoterapie epidemiologie imunologie virologie MeSH
- lidé MeSH
- počet CD4 lymfocytů MeSH
- RNA virová analýza MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa epidemiologie MeSH
- MeSH
- lidé MeSH
- meningitida epidemiologie patologie MeSH
- meningokoková meningitida terapie MeSH
- Neisseria meningitidis patogenita MeSH
- Check Tag
- lidé MeSH
- Geografické názvy
- Súdán MeSH
Porucha cirkadiánneho rytmu tlaku krvi (TK) u pacientov s artériovou hypertenziou je charakterizovaná chýbaním poklesu tlaku krvi v nočných hodinách (non dipper), je spojená so závažnejším stupňom ochorenia a vedie k akcelerovanému poškodeniu cieľových orgánov. Vplyv antihypertenzívnej liečby na úpravu cirkadiánneho rytmu TK nebol dostatočne sledovaný. 24 hodinové monitorovanie tlaku krvi pred a po 12-týždňovej liečbe lisinoprilom sme zrealizovali u 163 pacientov s miernou a stredne ťažkou hypertenziou. Po liečbe lisinoprilom došlo k signifikantnému poklesu systolického (139,5±13,07 vs 127,7±11,31 mm Hg); (p<0,001) a diastolického (83,1±8,37 vs. 75,3±7,75 mm Hg; (p<0,001) tlaku krvi. Nedošlo k zlepšeniu variability systolického (SD STK 15,2±3,54 vs. 15,2±3,92 mm Hg; NS) ani diastolického (SD DTK 11,6±2,67 vs. 12,1±3,01 mm Hg, NS) tlaku krvi. Došlo k zníženiu počtu pacientov s paradoxným vzostupom TK v nočných hodinách (16,4% vs 6,2%) (p<0,05) a non dipping chronogramu: 44,4% vs. 38,5%. Počet dipperov sa zvýšil z 32,7% na 39,5%. Po liečbe lisinoprilom došlo k signifikantnému poklesu systolického a diastolického tlaku krvi a k úprave cirkadiánneho rytmu tlaku krvi u pacientov s miernou a stredne ťažkou artériovou hypertenziou. Variabilita krvného tlaku nebola signifikantne zlepšená.
- MeSH
- ambulantní monitorování krevního tlaku MeSH
- cirkadiánní rytmus MeSH
- hypertenze farmakoterapie MeSH
- inhibitory ACE aplikace a dávkování farmakologie terapeutické užití MeSH
- lidé MeSH
- lisinopril aplikace a dávkování farmakologie terapeutické užití MeSH
- prospektivní studie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- MeSH
- diabetes mellitus 2. typu komplikace MeSH
- diabetické angiopatie MeSH
- diferenciální diagnóza MeSH
- inzulinová rezistence diagnóza klasifikace MeSH
- lidé MeSH
- rizikové faktory MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
