We aimed to assess the extent of integration of non‐communicable disease (NCD) assessment and management in HIV clinics across Europe.

(1) Background: Viral hepatitis C (HCV) and viral hepatitis B (HBV) are common co-infections in people living with HIV (PLWH). All PLWH should be vaccinated against HBV and hepatitis A (HAV) and treated for HBV and HCV. We aimed to compare testing, prophylaxis and treatment of viral hepatitis in PLWH in Central and Eastern Europe (CEE) in 2019 and 2022. (2) Methods: Data was collected through two on-line surveys conducted in 2019 and 2022 among 18 countries of the Euroguidelines in CEE (ECEE) Network Group. (3) Results: In all 18 countries the standard of care was to screen all PLWH for HBV and HCV both years; screening of HAV was routine in 2019 in 54.5% and in 2022 47.4% of clinics. Vaccination of PLWH against HAV was available in 2019 in 16.7%, in 2022 in 22.2% countries. Vaccination against HBV was available routinely and free of charge in 50% of clinics both in 2019 and 2022. In HIV/HBV co-infected the choice of NRTI was tenofovir-based in 94.4% of countries in both years. All clinics that responded had access to direct-acting antivirals (DAAs) but 50% still had limitations for treatment. (4) Conclusions: Although testing for HBV and HCV was good, testing for HAV is insufficient. Vaccination against HBV and especially against HAV has room for improvement; furthermore, HCV treatment access needs to overcome restrictions.

With no expected vaccine for HIV in the near future, we aimed to define the current situation and challenges for pre- and post-exposure prophylaxis (PrEP and PEP) in Central and Eastern Europe (CEE). The Euroguidelines CEE Network Group members were invited to respond to a 27-item survey including questions on PrEP (response rate 91.6%). PrEP was licensed in 68.2%; 95 centers offered PrEP and the estimated number on PrEP was around 9000. It was available in daily (40.1%), on-demand (13.3%), or both forms (33.3%). The access rate was <1–80%. Three major barriers for access were lack of knowledge/awareness among people who are in need (59.1%), not being reimbursed (50.0%), and low perception of HIV risk (45.5%). Non-occupational PEP was available in 86.4% and was recommended in the guidelines in 54.5%. It was fully reimbursed in 36.4%, only for accidental exposures in 40.9%, and was not reimbursed in 22.72%. Occupational PEP was available in 95.5% and was reimbursed fully. Although PrEP scale-up in the region has gained momentum, a huge gap exists between those who are in need of and those who can access PrEP. Prompt action is required to address the urgent need for PrEP scale-up in the CEE region.

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.

People living with HIV (PLWH) are at higher risk of poorer COVID‐19 outcomes. Vaccination is a safe and effective method of prevention against many infectious diseases, including COVID‐19. Here we investigate the strategies for national COVID‐19 vaccination programmes across central and eastern Europe and the inclusion of PLWH in vaccination programmes.

BACKGROUND Limited data exist comparing clinical outcomes of two-drug regimens (2DRs) and three-drug regimens (3DRs) in people living with HIV. METHODS Antiretroviral treatment-experienced individuals in RESPOND switching to a new 2DR or 3DR from 1/1/12-1/10/18 were included. The incidence of clinical events (AIDS, non-AIDS cancer, cardiovascular disease, end-stage liver and renal disease, death) was compared between regimens using Poisson regression. RESULTS Of 9791 individuals included, 1088 (11.1%) started 2DRs and 8703 (88.9%) 3DRs. The most common 2DRs were dolutegravir plus lamivudine (22.8%) and raltegravir plus boosted darunavir (19.8%); the most common 3DR was dolutegravir plus 2 nucleoside reverse transcriptase inhibitors (46.9%). Individuals on 2DRs were older (median 52.6 years [interquartile range 46.7-59.0] vs 47.7 [39.7-54.3]), and a higher proportion had ≥1 comorbidity (81.6% vs 73.9%).There were 619 events during 27,159 person-years of follow-up (PYFU): 540 (incidence rate [IR] 22.5/1000 PYFU [95% CI 20.7-24.5]) on 3DRs, 79 (30.9/1000 PYFU [24.8-38.5]) on 2DRs. The most common events were death (7.5/1000 PYFU [95% CI 6.5-8.6]) and non-AIDS cancer (5.8/1000 PYFU [4.9-6.8]). After adjustment for baseline demographic and clinical characteristics, there was a similar incidence of events on both regimen types (2DRs vs 3DRs IR ratio: 0.92 [0.72-1.19]; p=0.53). CONCLUSIONS This is the first large, international cohort assessing clinical outcomes on 2DRs. After accounting for baseline characteristics, there was a similar incidence of events on 2DRs and 3DRs. 2DRs appear to be a viable treatment option with regard to clinical outcomes; further research on resistance barriers and long-term durability of 2DRs is needed.

Pre‐exposure prophylaxis (PrEP) for HIV infection has been introduced in only a few European countries. We investigated the potential to provide PrEP in the Central and Eastern European region, and in neighbouring countries.

SUMMARY CONFLICT OF INTEREST: none declared. Introduction Brucella endocarditis (BE) is a rare but severe and potentially lethal manifestation of brucellosis. Pre-existing valves lesions and prosthetic valves (PV) are favorable for BE. Case report We represent the case of a 46-year-old man who was treated at the Clinic for Infectious Diseases, Clinical Center of Sarajevo University, as blood culture positive (Brucella melitensis) mitral and aortic PV endocarditis. He was treated with combined anti-brucella and cardiac therapy. Surgical intervention was postponed due to cardiac instability. Four months later he passed away. Surgery was not performed.

INTRODUCTION Osteoarticular manifestations of human brucellosis occur in 20-40% of patients while spondylodiscitis is the most severe form of the bone and joint structures involvements. AIM The aim of this paper is tho show clinical and radiological caracteristics of osteoarticular forms of brucellosis, with special reference to spondylodiscitis. MATERIAL AND METHODS The medical histories of 120 hospitalized patients at the Clinic for Infectious Diseases, Clinical Center of Sarajevo University, diagnosed with brucellosis, were analyzed. RESULTS Osteoarticular manifestations had sixty-nine patients, representing 78.4% of all localized forms of the disease. Spondylodiscitis represents 40.6% of all osteoarticular manifestations of the disease. Nine patients (32.1%) had paravertebral and paraspinal abscess. Median diagnostic interval for spondylodiscitis (116 +/- 160 days) was almost twice prolonged compared to the arthritis and sacroilitis (p < 0.05). The most common radiological manifestations were erosions of the vertebral surface (67.8%). Computerized tomography confirmed inflammation in 85.2% of the patients, while magnetic resonance imaging (MRI) showed radiological alterations in all patients (100%). DISCUSSION AND CONCLUSION Osteoarticular manifestations are the most common localised forms of brucellosis. The frequency of spondylodiscitis is in relation to duration of the diagnostic time. MRI shows a high degree of sensitivity to inflammatory changes of spine and "Pedro Pons' sign" is patognomic radiological alteration.

Listeria monocytogenes is a small, aerobic or facultative anaerobic, non-sporulating gram positive bacillus that can be isolated from soil, vegetation or animal reservoirs. There are six species of Listeria, and only L. monocytogenes is pathogenic for humans. Human disease occurs mainly in immunocompromised people, neonates and in pregnancy, while the cases in immunocompetent people are rare. CNS manifestations of the disease can be in form of meningitis, encephalitis, and also cerebritis and abscess since L. monocytogenes shows tropism for brain and brain stem as well for the meninges. In this case we presented 55 year old male patient with etiologically confirmed listerial meningoencephalitis, transferred from regional hospital tothe Clinic for Infectious Diseases with diagnosis of acute meningoencephalitis. Disease started 4 days before the admission. Prior to this the patient was completely healthy. In his history he denied any preexisting disease. At admittance he was febrile, with altered consciousness, disoriented, showing ocular deviation, dystaxia, and with completely positive meningeal signs. Neurologist diagnosis was rhombencephalitis. CSF analysis showed mildly opalescent liquor with pleocytosis 546/mm3 and polymorphonuclear cell predominance >70%. CSF culture showed positive isolate of L. monocytogenes. Initial therapy was: Penicillin G and Chloramphenicol, together with all other supportive and symptomatic therapy. After initial therapy and based on antibiogram, ampicillin was administered for4 weeks, followed by imipenemum for 10 days. Control CSF analysis showed pleocytosis and increased protein level and the patient was discharged as recovered with diagnosis of acute meningoencephalitis