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Peer-reviewedCC BY 4.0Infection

Changing patterns in the medical care of refugees with HIV from Ukraine

7 affiliations
  1. 1Department of Rheumatology and Immunology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
  2. 2Deutsches Zentrum für Infektionsforschung (DZIF), partner site Hannover- Braunschweig, Hannover, Germany
  3. 3Department of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
  4. 4Department of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
  5. 5Biomedical Research in End-stage and Obstructive Lung disease (BREATH), Deutsches Zentrum für Lungenforschung (DZL), Hannover, Germany
  6. 6European Reference Network on Rare and Complex Respiratory Diseases (ERN-LUNG), Frankfurt, Germany
  7. 7Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Hannover, Germany

Abstract

Since February 2022, the war in Ukraine has led to large-scale displacement, including people living with HIV (PLWH). Early reports described predominantly virologically suppressed individuals with preserved immune function. Data on refugees with HIV presenting during later phases of the war are limited. We conducted a retrospective single-center study including adult refugees with HIV from Ukraine presenting to a tertiary care center in Germany. Paticipants were grouped by time of presentation: Cohort 1 (March–December 2022) and Cohort 2 (January 2023–February 2024). Clinical, immunological, and virological parameters were compared between cohorts. A total of 86 individuals were included (Cohort 1: n = 46; Cohort 2: n = 40). Participants in cohort 2 more frequently received their first HIV diagnosis after presentation in Germany, with no previously documented HIV diagnosis in Ukraine or elsewhere, compared with cohort 1 (67% vs. 5%; p < 0.0001). Participants in Cohort 2 more often presented with detectable HIV RNA (65% vs. 29%; p < 0.0001) and advanced immunodeficiency (CD4 < 200/µL: 28% vs. 9%; p < 0.05). Among individuals with prior HIV diagnosis, virological failure was more common in Cohort 2 (50% vs. 14%; p = 0.006). AIDS-defining illnesses occurred more frequently in Cohort 2 (p = 0.005). Serological evidence of HBV and HCV infection was high in both cohorts. Refugees with HIV from Ukraine presenting during later phases of the war exhibit more advanced disease and poorer virological control compared with earlier arrivals. These findings suggest increasing disruption of HIV care over time and highlight the need for low-threshold access to testing, comprehensive screening, and rapid initiation of antiretroviral therapy in this population.

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BibTeX
@article{ahrenstorf2026changing,
  title = {{Changing patterns in the medical care of refugees with HIV from Ukraine}},
  author = {Gerrit Ahrenstorf and Alexandra Dopfer-Jablonka and Christine Knuth and Theresa Graalmann and Thea Thiele and Luca Wolf and Rene Abu Isneineh and Felix C. Ringshausen and Hortense Slevogt and Torsten Witte and Georg M. N. Behrens},
  journal = {Infection},
  year = {2026},
  month = jul,
  doi = {10.1007/s15010-026-02867-y},
  url = {https://doi.org/10.1007/s15010-026-02867-y},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Changing patterns in the medical care of refugees with HIV from Ukraine
AU  - Gerrit Ahrenstorf
AU  - Alexandra Dopfer-Jablonka
AU  - Christine Knuth
AU  - Theresa Graalmann
AU  - Thea Thiele
AU  - Luca Wolf
AU  - Rene Abu Isneineh
AU  - Felix C. Ringshausen
AU  - Hortense Slevogt
AU  - Torsten Witte
AU  - Georg M. N. Behrens
PY  - 2026
DA  - 2026/07/03
JO  - Infection
DO  - 10.1007/s15010-026-02867-y
UR  - https://doi.org/10.1007/s15010-026-02867-y
AB  - Since February 2022, the war in Ukraine has led to large-scale displacement, including people living with HIV (PLWH). Early reports described predominantly virologically suppressed individuals with preserved immune function. Data on refugees with HIV presenting during later phases of the war are limited. We conducted a retrospective single-center study including adult refugees with HIV from Ukraine presenting to a tertiary care center in Germany. Paticipants were grouped by time of presentation: Cohort 1 (March–December 2022) and Cohort 2 (January 2023–February 2024). Clinical, immunological, and virological parameters were compared between cohorts. A total of 86 individuals were included (Cohort 1: n = 46; Cohort 2: n = 40). Participants in cohort 2 more frequently received their first HIV diagnosis after presentation in Germany, with no previously documented HIV diagnosis in Ukraine or elsewhere, compared with cohort 1 (67% vs. 5%; p < 0.0001). Participants in Cohort 2 more often presented with detectable HIV RNA (65% vs. 29%; p < 0.0001) and advanced immunodeficiency (CD4 < 200/µL: 28% vs. 9%; p < 0.05). Among individuals with prior HIV diagnosis, virological failure was more common in Cohort 2 (50% vs. 14%; p = 0.006). AIDS-defining illnesses occurred more frequently in Cohort 2 (p = 0.005). Serological evidence of HBV and HCV infection was high in both cohorts. Refugees with HIV from Ukraine presenting during later phases of the war exhibit more advanced disease and poorer virological control compared with earlier arrivals. These findings suggest increasing disruption of HIV care over time and highlight the need for low-threshold access to testing, comprehensive screening, and rapid initiation of antiretroviral therapy in this population.
SN  - 0300-8126
SN  - 1439-0973
ER  -