University Hospital Galway Study Highlights Care for Ukrainian HIV Patients

Displaced Ukrainian patients arriving with complex infectious diseases have placed healthcare infrastructure at University Hospital Galway under pressure, according to a study published in the Irish Medical Journal.

Key Clinical Takeaways:

• University Hospital Galway evaluated 123 displaced adults from Ukraine across a 113-week evaluation window ending in April 2024.
• Seventy-five individuals in the cohort were living with HIV, including seven newly diagnosed patients, six of whom incurred an inpatient cost of €453,944 over 358 bed days.
• Treatment barriers included geographic distances averaging 103 kilometers, a reliance on professional language interpretation for 93.5% of patients, and regional supply chain gaps for standard antiretroviral regimens.

Financial and Inpatient Pressures at University Hospital Galway

The infectious diseases service at University Hospital Galway evaluated 123 adults from Ukraine over a 113-week period running between February 2022 and April 2024. Among the 123 patients reviewed, 75 individuals were living with HIV, and seven of these patients received their initial diagnosis after arriving in Ireland. Four of those seven newly diagnosed individuals presented with advanced disease, exhibiting symptoms of an AIDS-defining illness or opportunistic infection.

Overall, 26 patients required hospital admission, accumulating 597 inpatient bed days throughout the study window. Six of the newly diagnosed HIV patients alone required admission, accounting for 358 bed days at a calculated inpatient cost of €453,944.

Forced Migration Disrupts HIV Treatment and Medication Regimens

Clinicians observed that 68 patients carried a pre-existing HIV diagnosis, but the disruption caused by forced migration led to detectable viraemia—meaning the virus was actively circulating in the bloodstream—in 27 individuals. Furthermore, 46 patients required a switch in their antiretroviral therapy regimen because the standard fixed-dose combination commonly prescribed in Ukraine was unavailable in Ireland.

Hepatitis co-infections compounded these clinical management challenges. Active hepatitis C virus was identified in 69 patients across the cohort, which included 32 individuals co-infected with both HIV and hepatitis C. Chronic hepatitis B was detected in 13 patients.

Patients Face Multi-Drug Resistant Tuberculosis and Travel Barriers

Four individuals presented with active tuberculosis disease. Every single one of these four active tuberculosis cases featured multi-drug resistant isolates, signifying that the bacterial strains could not be defeated by the two most effective first-line treatments for the disease.

Patients encountered substantial logistical barriers to care across the region, travelling an average distance of 103 kilometers to attend clinic appointments. Just 50.4% of the participants managed to use public transport to get to the hospital within a two-hour window, whereas 93.5% needed professional language interpreters to facilitate dialogue during their clinical evaluations.

Proposed Service Expansions and Regional Integration

The study authors recommended targeted investment in migrant health services that reflects the scale and distribution of need across different regions. The team proposed expanding outreach medical clinics, incorporating virtual consultations, enhancing financial support for travel, and introducing migrant case managers or cultural mediators.

Disclaimer: The information provided in this article is for educational and scientific communication purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider regarding any medical condition, diagnosis, or treatment plan.

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