{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T18:54:30Z","timestamp":1778612070537,"version":"3.51.4"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,10,4]],"date-time":"2022-10-04T00:00:00Z","timestamp":1664841600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>In the last decade, substantial differences in the epidemiology of, antiretroviral therapy (ART) for, cascade of care in and support to people with HIV in vulnerable populations have been observed between countries in Western Europe, Central Europe (CE) and Eastern Europe (EE). The aim of this study was to use a survey to explore whether ART availability and therapies have evolved in CE and EE according to European guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Euroguidelines in Central and Eastern Europe (ECEE) Network Group conducted two identical multicentre cross\u2010sectional online surveys in 2019 and 2021 concerning the availability and use of antiretroviral drugs (boosted protease inhibitors [bPIs], integrase inhibitors [INSTIs] and nucleoside reverse transcriptase inhibitors [NRTIs]), the introduction of a rapid ART start strategy and the use of two\u2010drug regimens (2DRs) for starting or switching ART. We also investigated barriers to the implementation of these strategies in each region.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 18 centres participated in the study: four from CE, six from EE and eight from Southeastern Europe (SEE). Between those 2\u2009years, older PIs were less frequently used and darunavir\u2010based regimens were the main PIs (83%); bictegravir\u2010based and tenofovir alafenamide\u2010based regimens were introduced in CE and SEE but not in EE. The COVID\u201019 pandemic did not significantly interrupt delivery of ART in most centres. Two\u2010thirds of centres adopted a rapid ART start strategy, mainly in pregnant women and to improve linkage of care in vulnerable populations. The main obstacle to rapid ART start was that national guidelines in several countries from all three regions did not support such as strategy or required laboratory tests first; an INSTI\/NRTI combination was the most commonly prescribed regimen (75%) and was exclusively prescribed in SEE. 2DRs are increasingly used for starting or switching ART (58%), and an INSTI\/NRTI was the preferred regimen (75%) in all regions and exclusively prescribed in SEE, whereas the use of bPIs declined. Metabolic disorders and adverse drug reactions were the main reasons for starting a 2DR; in the second survey, HIV RNA &lt;500\u2009000 c\/ml and high cluster of differentiation (CD)\u20104 count emerged as additional important reasons.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In just 2\u2009years and in spite of the emergence of the COVID\u201019 pandemic, significant achievements concerning ART availability and strategies have occurred in CE, EE and SEE that facilitate the harmonization of those strategies with the European AIDS Clinical Society guidelines. Few exceptions exist, especially in EE. Continuous effort is needed to overcome various obstacles (administrative, financial, national guideline restrictions) in some countries.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.13416","type":"journal-article","created":{"date-parts":[[2022,10,5]],"date-time":"2022-10-05T05:08:38Z","timestamp":1664946518000},"page":"462-470","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["<scp>HIV<\/scp> treatment strategies across Central, Eastern and Southeastern Europe: New times, old problems"],"prefix":"10.1111","volume":"24","author":[{"given":"Antonios","family":"Papadopoulos","sequence":"first","affiliation":[{"name":"4<sup>th<\/sup> Department of Internal Medicine University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos","family":"Thomas","sequence":"additional","affiliation":[{"name":"4<sup>th<\/sup> Department of Internal Medicine University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos","family":"Protopapas","sequence":"additional","affiliation":[{"name":"4<sup>th<\/sup> Department of Internal Medicine University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergii","family":"Antonyak","sequence":"additional","affiliation":[{"name":"Gromashevsky Institute of Epidemiology and Infectious Diseases Viral Hepatitis and AIDS Department  Kiev Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josip","family":"Begovac","sequence":"additional","affiliation":[{"name":"University Hospital for Infectious Diseases  Zagreb Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gordana","family":"Dragovic","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Clinical Pharmacology and Toxicology, School of Medicine University of Belgrade  Belgrade Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deniz","family":"G\u00f6kengin","sequence":"additional","affiliation":[{"name":"Ege University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology  Izmir Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kersti","family":"Aimla","sequence":"additional","affiliation":[{"name":"West Tallinn Central Hospital  Tallinn Estonia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valbon","family":"Krasniqi","sequence":"additional","affiliation":[{"name":"Infectious Diseases Clinic University Clinical Center at Kosovo  Prishtina Kosovo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Botond","family":"Lakatos","sequence":"additional","affiliation":[{"name":"National Institute of Hematology and Infectious Diseases South\u2010Pest Central Hospital, National Center of HIV  Budapest Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariana","family":"Mardarescu","sequence":"additional","affiliation":[{"name":"National Institute for Infectious Diseases Matei Bals  Bucharest Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raimonda","family":"Matulionyte","sequence":"additional","affiliation":[{"name":"Vilnius University Faculty of Medicine, Vilnius University Hospital Santaros Klinikos  Vilnius Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Velida","family":"Mulabdic","sequence":"additional","affiliation":[{"name":"Clinic for Infectious Diseases, Clinical Center University of Sarajevo  Sarajevo Bosnia and Herzegovina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9581-2527","authenticated-orcid":false,"given":"Cristiana","family":"Oprea","sequence":"additional","affiliation":[{"name":"Carol Davila University of Medicine and Pharmacy Victor Babes Clinical Hospital for Infectious and Tropical Diseases  Bucharest Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aleksandr","family":"Panteleev","sequence":"additional","affiliation":[{"name":"City TB Hospital # 2  St\u2010Petersburg Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dalibor","family":"Sedl\u00e1\u010dek","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Travel Medicine Charles University of Prague  Prague Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lubomir","family":"Sojak","sequence":"additional","affiliation":[{"name":"Department of Infectology and Geographical Medicine Academic L. Derer's University Hospital  Bratislava Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6367-5633","authenticated-orcid":false,"given":"Agata","family":"Skrzat\u2010Klapaczy\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Adults' Infectious Diseases, Hospital for Infectious Diseases Medical University of Warsaw  Warsaw Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Vassilenko","sequence":"additional","affiliation":[{"name":"Republican Scientific and Practical Center for Medical Technologies, Global Fund Grant Management Department Belarusian State Medical University  Minsk Belarus"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Yancheva","sequence":"additional","affiliation":[{"name":"Department for AIDS Specialized Hospital for Active Treatment of Infectious and Parasitic Diseases  Sofia Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oleg","family":"Yurin","sequence":"additional","affiliation":[{"name":"Central Research Institute of Epidemiology  Moskow Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrzej","family":"Horban","sequence":"additional","affiliation":[{"name":"Department of Adults' Infectious Diseases, Hospital for Infectious Diseases Medical University of Warsaw  Warsaw Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1166-4462","authenticated-orcid":false,"given":"Justyna D.","family":"Kowalska","sequence":"additional","affiliation":[{"name":"Department of Adults' Infectious Diseases, Hospital for Infectious Diseases Medical University of Warsaw  Warsaw Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the Euroguidelines in Central and Eastern Europe Network Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,10,4]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"2021 UNAIDS Global AIDS Update\u2014confronting inequalities\u2014lessons for pandemic responses from 40\u2009years of AIDS. 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