{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T16:04:42Z","timestamp":1777046682671,"version":"3.51.4"},"reference-count":33,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T00:00:00Z","timestamp":1694563200000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Eastern 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We described an HIV cascade of care (CoC) in PLHIV from two clinical sites and an HCV CoC for anti\u2010HCV\u2010positive PLHIV from six sites in Ukraine, enrolled in the CARE cohort between 1 January 2019 and 1 June 2020. The cross\u2010sectional HIV CoC and HCV CoC are described at study enrolment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 1028 PLHIV, 1014 (98.6%, 95% confidence interval [CI] 97.7\u201399.3) were on antiretroviral therapy (ART), and 876 (86.4% of those on ART, 95% CI 84.1\u201388.4) were virologically suppressed. Of 894 participants on ART &gt;6 months, 90.8% (95% CI 88.7\u201392.6) were virologically suppressed (HIV\u2010RNA &lt;200 copies\/ml). Of 2040 anti\u2010HCV\u2010positive PLHIV, 417 (20.4%, 95% CI 18.7\u201322.3) were ever tested for HCV\u2010RNA prior to enrolment, ranging from 4.9% to 54.4% across sites, and 13.5% were currently HCV\u2010RNA 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%\u20137.5%). The site diagnosing 54.4% of people with chronic HCV was the only one providing free RNA testing for all anti\u2010HCV\u2010positive persons, while the intra\u2010country differences in treatment coverage were driven by the number of available direct\u2010acting antiviral (DAA) courses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Over 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 &gt;6 months on ART. Only one of six HIV\/HCV study sites tested over 50% anti\u2010HCV\u2010positive PLHIV for HCV\u2010RNA and treated over 25% of eligible persons. While free HCV\u2010RNA testing and DAA treatment are paramount to achieving HCV elimination targets, they remained a challenge in Ukraine in 2019\u20132020. 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\u2010war findings.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.26166","type":"journal-article","created":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T13:13:45Z","timestamp":1694697225000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Cross\u2010sectional HIV and HCV cascades of care across the regions of Ukraine between 2019 and 2020: findings from the CARE cohort"],"prefix":"10.1002","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1596-9880","authenticated-orcid":false,"given":"Olga","family":"Fursa","sequence":"first","affiliation":[{"name":"Centre of Excellence for Health, Immunity and Infections Rigshospitalet  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne","family":"Reekie","sequence":"additional","affiliation":[{"name":"Centre of Excellence for Health, Immunity and Infections Rigshospitalet  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ihor","family":"Kuzin","sequence":"additional","affiliation":[{"name":"Public Health Center of the Ministry of Health of Ukraine  Kyiv Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larysa","family":"Hetman","sequence":"additional","affiliation":[{"name":"Public Health Center of the Ministry of Health of Ukraine  Kyiv Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alina","family":"Kryshchuk","sequence":"additional","affiliation":[{"name":"Public Health Center of the Ministry of Health of Ukraine  Kyiv Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olena","family":"Starychenko","sequence":"additional","affiliation":[{"name":"Kyiv City AIDS Prevention and Control Center (Kyiv City Clinical Hospital \u21165)  Kyiv Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nana","family":"Hrytsaiuk","sequence":"additional","affiliation":[{"name":"Kyiv City AIDS Prevention and Control Center (Kyiv City Clinical Hospital \u21165)  Kyiv Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inna","family":"Khodus","sequence":"additional","affiliation":[{"name":"Kyiv Regional Center for Public Health  Kyiv Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alla","family":"Nyzhnyk","sequence":"additional","affiliation":[{"name":"Kyiv Regional Center for Public Health  Kyiv Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viktoriia","family":"Rakhuba","sequence":"additional","affiliation":[{"name":"Kyiv Regional Center for Public Health  Kyiv Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryna","family":"Kovalevska","sequence":"additional","affiliation":[{"name":"Kyiv Regional Center for Public Health  Kyiv Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetiana","family":"Maistat","sequence":"additional","affiliation":[{"name":"Regional Clinical Center for AIDS Prevention and Control of Kharkiv Regional Council  Kharkiv Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iryna","family":"Pryhoda","sequence":"additional","affiliation":[{"name":"Mariupol City Hospital \u21164 named after I.K. Matsuka  Mariupol Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianna","family":"Ahieieva","sequence":"additional","affiliation":[{"name":"Odesa City AIDS Prevention and Control Center  Odesa Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olena","family":"Varvarovska","sequence":"additional","affiliation":[{"name":"Regional Medical Specialized Center of Zhytomyr Regional Council  Zhytomyr Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olena","family":"Valdenmaiier","sequence":"additional","affiliation":[{"name":"Centre of Excellence for Health, Immunity and Infections Rigshospitalet  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens","family":"Lundgren","sequence":"additional","affiliation":[{"name":"Centre of Excellence for Health, Immunity and Infections Rigshospitalet  Copenhagen 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