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AbstractIntroductionEastern Europe is facing major HIV and hepatitis C (HCV) epidemics, with many people living with HIV (PLHIV) and HIV/HCV coinfection living in Ukraine. Despite the previous progress towards care quality improvement, the ongoing war in Ukraine is disrupting HIV and HCV care.MethodsWe described an HIV cascade of care (CoC) in PLHIV from two clinical sites and an HCV CoC for anti‐HCV‐positive PLHIV from six sites in Ukraine, enrolled in the CARE cohort between 1 January 2019 and 1 June 2020. The cross‐sectional HIV CoC and HCV CoC are described at study enrolment.ResultsOf 1028 PLHIV, 1014 (98.6%, 95% confidence interval [CI] 97.7–99.3) were on antiretroviral therapy (ART), and 876 (86.4% of those on ART, 95% CI 84.1–88.4) were virologically suppressed. Of 894 participants on ART >6 months, 90.8% (95% CI 88.7–92.6) were virologically suppressed (HIV‐RNA <200 copies/ml). Of 2040 anti‐HCV‐positive PLHIV, 417 (20.4%, 95% CI 18.7–22.3) were ever tested for HCV‐RNA prior to enrolment, ranging from 4.9% to 54.4% across sites, and 13.5% were currently HCV‐RNA positive. One hundred and eighteen persons (7.3% of ever chronically infected) had received HCV treatment, and 25 persons (1.6% of ever chronically infected) were cured, with variations across sites (0%–7.5%). The site diagnosing 54.4% of people with chronic HCV was the only one providing free RNA testing for all anti‐HCV‐positive persons, while the intra‐country differences in treatment coverage were driven by the number of available direct‐acting antiviral (DAA) courses.ConclusionsOver 98% of PLHIV in care in both CARE sites in Ukraine were receiving ART, and the target of 90% virally suppressed was achieved in persons >6 months on ART. Only one of six HIV/HCV study sites tested over 50% anti‐HCV‐positive PLHIV for HCV‐RNA and treated over 25% of eligible persons. While free HCV‐RNA testing and DAA treatment are paramount to achieving HCV elimination targets, they remained a challenge in Ukraine in 2019–2020. The extent of the HIV and HCV care disruption during the war will be further assessed in the CARE cohort and compared with the pre‐war findings.

To access publisher's full text version of this article click on the hyperlink below ; According to guidelines all HIV-HBV-coinfected patients should receive tenofovir-based combination antiretroviral therapy (cART). We aimed to investigate uptake and outcomes of tenofovir-based cART among HIV-HBV patients in the EuroSIDA study. All hepatitis B surface antigen (HBsAg)+ patients followed up after 1 March 2002 were included. Changes in the proportion taking tenofovir-based cART over time were described. Poisson regression was used to investigate the relationship between tenofovir use and clinical events. 953 HIV-HBV patients were included. Median age was 41 years and patients were predominantly male (85%), White (82%) and ART-experienced (88%). 697 and 256 were from Western and Eastern Europe, respectively. 55 started cART during follow-up, the proportion starting with CD4 Although use of tenofovir-based cART among HIV-HBV patients has increased across Europe, a substantial proportion are still starting cART late and are receiving suboptimal HBV therapy. ; European Union's Seventh Framework Programme for research, technological development and demonstration Bristol-Myers Squibb Gilead GlaxoSmithKline LLC Janssen RD Merck and Co. Inc. Pfizer Inc. Swiss National Science Foundation Danish National Research Foundation