Continuity of HIV and Hepatitis C Care in Times of War – Five Times Ninety Project
Five Times Ninety project investigates the utility of “Standardized protocol for clinical management and medical data sharing for PLHIV among refugees from Ukraine”.
Methods
Refugees who registered to HIV care in Warsaw, Poland were followed according to the protocol. For each person data were linked to Public Health Center Ministry of Health Ukraine and sent back on standardized form. Data were censored at 31.12.2023. Analyses were performer using Rv. 4.4.1 software.
Results
Of 205 refugees, who registered to HIV care in Warsaw, 202 (98.7 %) were linked with PHC database; 121 (59.9 %) were female, median age was 40.0 (IQR 36.0–46.0), migrating mainly from Central Ukraine (67; 33.2 %), diagnosed with HIV between 1996 and 2022 and 52 (25.9 %) persons ever diagnosed with. All patients were on ART: 167 (84.8 %) on dolutegravir one tablet regimen and 178 (90.8 %) had HIV viral load < 50 copies/ml on last measurement in Ukraine. Most refugees (128; 63.4 %) remained in care with 179 (88.6 %) having two, 159 (78.7 %) having three, 139 (68.8 %) having four, 107 (53.0 %) having five visits. Of 59 (31.5 %) tested positive for HCV serology in Poland, 24 were already treated in Ukraine, 25 had detectable HCV RNA and 10 received therapy in Poland
Conclusions
The protocol is an efficient tool for medical data exchange in the forced migration settings. Viral suppression among Ukrainian refugees on ART decreased but remained high and improving with time. Routine HCV screening is necessary, as large proportion of this population was not screened and many of them require treatment.