The new EACS guidelines for HIV treatment were presented on the recently finished EACS 2015 Conference. The new guidelines, version 8.0 include changes in almost all sections of the guidelines, and in the best way reflect the program and the most interesting segments of the Conference.
Primarily the guidelines suggest initiating antiretroviral treatment (ART) right away. ART is recommended to all people who are HIV positive, regardless of their CD4 count. Key reasons for this change are the results of the START study which has shown favorable clinical results for HIV positive people who started ART at a high CD4 count compared to people who started at a lower CD4 count.
Some initial combinations have been changed, so that the first line regiments were reduced from 13 to 6 options. Of the 6 recommended combination for initiating treatment, 4 were based on integrase inhibitors – INSTI (DTG and TDF/FTC or ABC/3TC, TDF/FTC/EVG/C and TDF/FTC + RAL), one on non nucleoside reverse transcriptase inhibitors – NNRTI (RPV/TDF/FTCO and one on protease inhibitors – PI (DRV/r + TDF/FTC).
Another significant innovation in this section relates to co-infections, particularly Hepatitis C, in the sense that this section was updated to reflect the significant advance in HCV treatment with direct acting antivirals – DAA, and phasing out of interferon based treatments.
Based on the PATNER study, recommendations on the post-exposure prophylaxis (PEP) have been revised in such a way that if exposure occurred with an HIV positive person who was documented as non-detectable regarding HIV RNA, PEP is no longer recommended. The recommended ART regiment for PEP is TDF/FTC + RAL or DRV/r.
A new section on the pre-exposure prophylaxis (PrEP) was added in these Guidelines. PrEP (TDF/FTC) should be recommended to people who are under increased risk from the HIV infection, including MSM and transgender people but also heterosexual men and women.
So the current guidelines for HIV treatment reflect the newest knowledge and science. We are left with the dilemma of how to apply them to countries with limited resources, or countries that do not devote enough attention to response to HIV and co-infections, like Serbia. At least we know what we should strive for.
The new guidelines are available at: http://www.eacsociety.org/guidelines/eacs-guidelines/eacs-guidelines.html
Fifteenth biannual European AIDS Conference took place on October 20-24th in Barcelona. The conference was organised by the European AIDS Clinical Society (EACS), and it gathered more than 3500 delegates – healthcare professionals and activists from all over Europe.
This important meeting always produces a diverse range of new and important research and this year was no exception. The Conference aims at presenting and critically discussing new knowledge as a fundamental part of good clinical practice and health care, whether to deal with HIV transmission, Hepatitis C and other co-infections, as well as co-morbidities. There were more than 600 lectures, poster presentations and webinars. This year’s program included a Society Networking Event taking place in order to facilitate quality international networking and cooperation.
There were several doctors and activities from Serbia participating in the Conference, among them Nada Mićić, Nenad Petković and Denis Memišević from Q-Club.
More about the conference: http://www.eacs-conference2015.com
Following the Beyond VCT meeting in Barcelona, representative of the Q-Club used the opportunity to visit one of the leading European Checkpoints – the BCN Checkpoint.
The BCN Checkpoint is completely community based and operated – including VCT councilors, volunteers, and people participating as campaign models. It is situated in the gay quart of Barcelona. It provides rapid tests for HIV, Hepatitis C, and other STIs, and most of the work of the Checkpoint is focused toward the MSM population.
Over almost one decade of their work, the BCN Checkpoint has established significant relationships with healthcare institutions in Spain. It is currently participating in a research for confirmatory rapid tests which include viral load tests with significantly increased sensitivity and decreased window period.
Checkpoints – Beyond VCT centers - Next steps for community testing in Europe – was the meeting of community testing centers across Europe which took place in Barcelona on 20th of October 2015.
New technologies used in the leading community based VCT centers in the community were presented on the meeting, as well as practices in using PrEP with the help of a community center, but also outreach and communication with key populations and vulnerable groups. Some of the presented new technologies included confirmatory testing with viral loads tests, or use of Insti tests, giving results within 60 seconds. This also included good practices for reaching out to people form key populations by using dating applications and websites, as well as automated notification system on recommending HIV testing.
A key part of the meeting was the discussion on how to improve community testing, and identifying next steps for getting a higher participation of the people from the community in HIV prevention, but also other STIs all across Europe.
A representative of Q-Club participated the meeting.
Pharmaceutical and medical fair – Expo Medic was organized for the first time in Serbia, modeled on similar fairs in the World. The Fair took place from October 15th to 17th in the Trade Unions House in Belgrade, and it was organised by the Chamber of Commerce of Belgrade – the Group of manufacturers, distributors and service providers, and the Healthcare secretariat of the City of Belgrade.
The exhibitors on the fair had an opportunity to present new developments in drugs, medical products, diet supplements, functional food, cosmetics. The Exhibitors were paharmaceutical companies, drugs manufacturers, healthcare institutions as well as patient groups.
Q-Club was one of the civil society organizations which presented their work on the Fair.