National Center for Disease Control and Prevention, Yerevan, Armenia.
School of Medicine, University of Zagreb, Zagreb, Croatia.
HIV Med. 2021 Jan;22(1):67-72. doi: 10.1111/hiv.12960. Epub 2020 Oct 5.
Pre-exposure prophylaxis (PrEP) for HIV infection is an important intervention for control of the HIV epidemic. The incidence of HIV infection is increasing in the countries of Central and Eastern Europe (CEE). Therefore, we investigated the change in PrEP use in CEE over time.
The Euroguidelines in Central and Eastern Europe (ECEE) Network Group was initiated in February 2016 to compare standards of care for HIV and viral hepatitis infections in CEE. Data on access to PrEP were collected from 23 countries through online surveys in May-June 2017 (76 respondents) and in November 2018-May 2019 (28 respondents).
About 34.2% of respondents stated that tenofovir/emtricitabine (TDF/FTC) was licensed for use in their country in 2017, and 66.7% that it was licensed for use in 2018 (P = 0.02). PrEP was recommended in national guidelines in 39.5% of responses in 2017 and 40.7% in 2018 (P = 0.378). About 70.7% of respondents were aware of "informal" PrEP use in 2017, while 66.6% were aware of this in 2018 (P = 0.698). In 2018, there were 53 centres offering PreP (the highest numbers in Poland and Romania), whereas six countries had no centres offering PreP. The estimated number of HIV-negative people on PreP in the region was 4500 in 2018. Generic TDF/FTC costs (in Euros) ranged from €10 (Romania) to €256.92 (Slovakia), while brand TDF/FTC costs ranged from €60 (Albania) to €853 (Finland).
Although the process of licensing TDF/FTC use for PrEP has improved, this is not yet reflected in the guidelines, nor has there been a reduction in the "informal" use of PrEP. PrEP remains a rarely used preventive method in CEE countries.
艾滋病毒感染的暴露前预防（PrEP）是控制艾滋病毒流行的一项重要干预措施。艾滋病毒感染的发病率在中东欧国家（CEE）不断上升。因此，我们研究了该地区 PrEP 使用随时间的变化。
2016 年 2 月发起了中东欧欧洲准则（ECEE）网络小组，以比较 CEE 艾滋病毒和病毒性肝炎感染的护理标准。通过 2017 年 5 月至 6 月（76 名受访者）和 2018 年 11 月至 2019 年 5 月（28 名受访者）的在线调查，从 23 个国家收集了 PrEP 获得情况的数据。
约 34.2%的受访者表示，替诺福韦/恩曲他滨（TDF/FTC）在 2017 年在其国家获得许可使用，66.7%的受访者表示在 2018 年获得许可使用（P=0.02）。2017 年有 39.5%的回应推荐了国家指南中的 PrEP，2018 年有 40.7%（P=0.378）。约 70.7%的受访者在 2017 年了解到“非正式”PrEP 的使用，而 2018 年为 66.6%（P=0.698）。2018 年，有 53 个中心提供 PreP（波兰和罗马尼亚的数量最高），而 6 个国家没有提供 PreP 的中心。该地区估计有 4500 名 HIV 阴性人群在使用 PreP，2018 年。通用 TDF/FTC 费用（欧元）范围从 10 欧元（罗马尼亚）到 256.92 欧元（斯洛伐克），而品牌 TDF/FTC 费用范围从 60 欧元（阿尔巴尼亚）到 853 欧元（芬兰）。
尽管 TDF/FTC 用于 PrEP 的许可使用过程有所改善，但这并未反映在指南中，也没有减少 PrEP 的“非正式”使用。PrEP 仍然是 CEE 国家很少使用的预防方法。
