Last year, 267 new cases of HIV (human immunodeficiency virus) were registered in Lithuania. This is significantly more than in 2021 when 121 cases were diagnosed. Specialists attribute the rapid growth of the disease to immigration.
The data from the National Public Health Centre (NVSC) shows that almost half of the new HIV cases in both 2022 and last year were diagnosed to people who were recent arrivals to the country.
“Specifically, war refugees from Ukraine. Most of the people infected with HIV are Ukrainian women. They make up the vast majority of those infected among foreign nationals,” noted Raimonda Matulionytė, Infectious Diseases Physician at Santaros Clinics.
According to her, both Ukraine and Russia are classified as high HIV prevalence countries. There, the HIV prevalence in the adult population is a bit more than 1 percent.
“Before Russia’s war against Ukraine, the number of HIV cases in our country was in line with the EU average. Since 2022, with the refugee wave, the number of HIV cases in our country has been rising and has not stopped. We are now above the EU average. The highest HIV incidence rate in 2023 was registered in Vilnius County,” said Matulionytė.
“According to the Ukrainian authorities, around 70 percent of those infected with HIV are aware of it and are receiving treatment. In our country, the majority of citizens of that country also go to treatment facilities knowing their diagnosis and requesting treatment. But there are certainly some people who did not know they were infected with HIV until we found out,” the physician added.
Should we worry?
Around 40 percent of all newly registered HIV cases in Lithuania are foreign nationals, most of whom are Ukrainians, notes Kęstutis Rudaitis, chief specialist at the NVSC.
“All the newcomers who have come to our treatment facilities are aware of the importance of taking medication and not spreading the infection when they have HIV. In other words, they take part in the prevention of the disease,” he says.
According to infectologist Matulionytė, the increase in HIV cases is worrying.
“The number of people living with HIV should not increase at all. Compared to 2010, we should count 70-percent fewer cases of this infection. Some countries have achieved this. The only regions where cases are not only not decreasing, but increasing, are Eastern Europe and Central Asia. Now we have joined in,” she said.
“The problem is that around a third of infected people ignore treatment. They simply do not turn up at treatment facilities. By delaying seeking help, HIV-positive people allow the infection to progress to the point where, by the time they finally turn to specialists, it is too late to help many of them. Often, they have already reached the final stage of HIV infection – AIDS – when their immunity is completely exhausted,” the doctor adds.
Last year alone, 37 AIDS cases were diagnosed in Lithuania.
NVSC specialist Rudaitis, however, does not see a risk in an increase in the number of newly registered HIV cases.
“The doubling of the number of cases does not indicate a worsening situation. Most of the new arrivals have already received treatment in their home country and are continuing their treatment with us,” he said.
“However, it is worrying that we are seeing a growing trend in Lithuania where the majority of people are contracting HIV through sexual contact rather than injecting drugs,” the expert added.
According to the NVSC, the most common mode of HIV transmission is sexual, accounting for 67.8 percent of cases, followed by drug injection (16.5 percent). The mode of transmission is unknown in 14.6 percent of cases.
Expanded testing
According to Matulionytė, as many as two-thirds of people living with HIV are found not to use or rarely use condoms, which can reduce the risk of HIV transmission.
“This is also a big problem, even though pre-exposure prophylaxis for HIV now exists. These are antiviral drugs that help protect against HIV infection. This is one of the newest and most effective tools to fight the HIV epidemic. They are given to people who are not infected with HIV but are at risk. However, these drugs are not yet covered by the national health insurance in Lithuania. Meanwhile, condoms are less used worldwide,” she said.
The doctor notes that HIV treatment in Lithuania today is very patient-friendly and fully covered by national health insurance. One pill a day is usually enough. The drugs are well tolerated but need to be taken for the rest of the patient’s life. There is no cure for HIV yet, but if tackled early, an infected person’s survival rate is almost the same as in the general population.
Meanwhile, Rudaitis believes that HIV testing should be expanded to control the spread of the infection. He recommends that every adult should be tested for HIV at least once in their lifetime and that those at risk should be tested once a year.
“The first symptoms of HIV are similar to those of cold or flu. Fever, sore throat, enlarged lymph nodes and rashes may appear within about three weeks,” the NVSC specialist noted.
“These are not signs that would make a person suspect HIV infection. Therefore, after these symptoms have passed, a person can live for years without even suspecting that they are infected,” he added. “Another thing that prevents people from getting tested is fear and shame.”
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