Galway doctors warn of challenges treating HIV patients from Ukraine
Six newly diagnosed HIV patients required admission, accounting for 358 bed days alone at a calculated inpatient cost of €453,944, a new study shows
The arrival of displaced Ukrainians with serious infectious conditions such as TB and HIV has placed healthcare infrastructure at University Hospital Galway (UHG) under pressure, a new study has revealed.
Doctors at the hospital evaluated 123 adults from Ukraine who newly attended their infectious diseases service over a 113-week period between February 2022 and April 2024 as part of the study.
The findings, published in the latest issue of the Irish Medical Journal, provide a snapshot of their experience managing high rates of HIV, hepatitis, and multidrug-resistant tuberculosis (TB).
Among the 123 patients reviewed, 75 individuals were living with HIV, and seven of these patients were newly diagnosed after arriving in Ireland.
Four of the seven newly diagnosed patients presented with advanced disease, showing symptoms of an AIDS-defining illness or opportunistic infection.
Overall, 26 patients required hospital admission, accumulating 597 inpatient bed days over the study window. Six of the newly diagnosed HIV patients required admission, accounting for 358 bed days alone at a calculated inpatient cost of €453,944.
The clinicians observed that 68 patients had a pre-existing HIV diagnosis, but the disruption caused by forced migration led to detectable viraemia – the presence of the virus circulating in the bloodstream – in 27 individuals.
Furthermore, 46 patients required a switch in their antiretroviral therapy (ART) regimen because the standard fixed-dose combination commonly prescribed in Ukraine is not available in Ireland.
Hepatitis co-infections were also prevalent, with active hepatitis C virus (HCV) identified in 69 patients across the cohort, including 32 individuals who were co-infected with both HIV and HCV.
Chronic hepatitis B (HBV) was detected in 13 patients, while four individuals presented with active tuberculosis disease.
All four active tuberculosis cases involved multi-drug resistant isolates, meaning the bacterial strain was resistant to the two most potent first-line medications used to treat the illness.
The authors noted that patients encountered substantial logistical barriers to care across the region, travelling an average distance of 103km to attend clinic appointments.
Only 50.4% of the cohort could access public transport to reach the hospital within two hours, while 93.5% required professional language interpretation to communicate during clinical assessments.
“These findings indicate a need for targeted investment in migrant health services that reflects the scale and distribution of need across different regions,” the authors wrote.
The team recommended expanding outreach medical clinics and incorporating virtual consultations, alongside enhancing financial support for travel and introducing migrant case managers or cultural mediators.