• New options and opportunities in PrEP

    (A report back on Kavita Misra's session - New options and opportunities in PrEP: Impact of PrEP on drug resistance and acute HIV infection, New York City 2015-2017)

    Data on PrEP and associated resistance comes from safety and efficacy studies.  Mathematical modelling has suggested that any contribution from PrEP to resistance mutations would be very small and lower than if HIV infections were not averted. Concerns relate to starting PrEP during seroconversion and acquiring HIV and continuing the two drug regimen. 

     

    Continue reading…

  • Treatment of Acute HCV Advocated

    (A report back on Sanjay Bhagani's session - Dynamics of Acute HCV in Western Europe​)

    Sanjay Bhagani talked about the status of acute HCV in Western Europe: compliance with the Global Health Sector Strategy (GHSS) call for the elimination of viral hepatitis as a public health threat by 2030, and the WHO reports on the significant obstacles to that strategy which include underdiagnosis and poor uptake of treatment in those diagnosed.

    Continue reading…

  • Randomised Controlled Trial of Intrauterine Device Safety in women living with HIV

    (A report back on Catherine Todd's session - Randomised Controlled Trial of Intrauterine Device Safety in women living with HIV)

    Intrauterine contraceptive devices both Copper containg IUD (C-IUD) & progesterone containing IUD (LNG-IUD) are under utilised in HIV high prevalence settings.  LNG-IUD efficacy has been under contraversy with EFV containing ART regimens. 

    Continue reading…

  • LGV Proctitis Treatment in HIV-infected MSM

    (A report back on Jose Blanco's session - Effective Treatment of Lymphogranuloma proctitis with extended azithromycin regimen)

    Jose Blanco presented an alternative and effective treatment to LGV proctitis utilising azithromycin 1 gm po weekly x 3 weeks. This was based on their study-analysis of 125 HIV-infected MSM who were randomised to either the standard treatment of doxycycline 100mg BD x 21 days or to the extended azithromycin regimen. Both arms produced equally effective cures in both symptomatic (12 weeks) and microbial (defined as a negative rectal PCR in 4-6 weeks) end points.

    Continue reading…

  • Aus GPs End Hep C

    ASHM's Treating Hepatitis C in General Practice Forum in Adelaide was a phenomenal event.  This was not only the first of its kind in Australia, but also the first of its kind anywhere in the world!

    The ability to sit down with GPs from all over Australia and discuss the challenges and successes that we have faced over the past 2 years with Hep C treatment was motivating.   The forum focused on inspiring and empowering GPs from across Australia to roll up the sleeves and get stuck into treating hepatitis C in their practices.  This forum highlighted the fact that Australia is in a unique situation, the envy of many other nations, with GPs having such great access and ability to prescribe DAA therapy to their patients.

    There were many great ideas and thoughts that I walked away with.  But the main one was that GPs have this amazing opportunity not just to be part of Hep C elimination but to be in the driving seat!

    Continue reading…

  • Hepatitis C Treatment in General Practice

    I attended the Treating Hepatitis C in General Practice Forum in Adelaide, thanks to a scholarship I received from ASHM and The Kirby Institute. The Forum addressed the goal of hepatitis C elimination by 2030, and the number of people who still need to be treated to achieve this goal. It focused on how to increase Hepatitis C treatment in general practice, and delivered useful information how to overcome barriers in our clinics.

    All the speakers were wonderful. They shared their experiences in treating patients with hepatitis C and provided motivational stories to us. 

     

    Continue reading…

  • Finding a Cure

    A report on Sarah Fidler’s presentation “Approaches towards a cure for HIV” 

    Sarah Fidler opened her lecture on HIV cure by provocatively asking – with the advances in drug therapy in the last decade, do we even need a cure? Of course with the financial costs of ARVs in addition to the potential impacts of ageing with HIV, a cure is ideal. 

    The sterilising cure, used 9 years ago in the Berlin patient, has been thus far unreproducible. Redefining our expectations is an important first step to recognise the potential for products in the pipeline. Aiming therefore for a “functional cure”, one with a very low sustained viral load, could be achievable. This would allow for host control of viral replication without continued treatment, immune function restored, as well as stabilised, HIV-induced inflammation reduced, and very low risk of transmission to others. 

    Continue reading…

  • We need better strategies who migrate and are at risk of HIV

    A report on Julia Del Amo’s presentation “HIV and Migration: a renewed challenge”

    Julia del Amo challenged our assumptions about HIV and migrants, with particular focus on Europe. Some migrants arrive to their destination country already living with HIV, either acquiring it in their port of origin or during their journey. However, the number of men who acquire HIV after they migrate is startling. 

    There are steadily increasing numbers of MSM who are diagnosed within the first year of living in their destination country (up 58% since 2007), while people who are heterosexual and newly diagnosed is declining (down 36% from 2007).  Moreover, in migrants from sub-Saharan Africa who are found to have HIV a year after arrival, approximately 72% of MSM and 50% of heterosexual migrants acquired HIV post-migration. This is determined using a validated method of estimating acquisition. 

    Continue reading…

  • What can we (in Australia) learn from HIV & Migration in Europe?

    A report on Julia Del Amo's presentation "HIV & Migration: a Renewed Challenge"

    Since 2015, Europe has been in the grip of a “Migrant Crisis”1 , shifting the population landscape in some countries and a change in the political climate.

    As Julia Del Amo from the National Center for Epidemiology, Institute of Health Carlos III, Madrid explained in her session “HIV & Migration: a Renewed Challenge”, the UN definition of a migrant is incredibly broad2 and this is reflected in the challenges that are faced domestically, politically and economically when considering these groups. She delivered an enlightening presentation on Wednesday morning at the Glasgow 2018 conference outlining patterns of HIV such as country of origin for newly acquired HIV cases & HIV positive migrants in Europe; acquisition method and trends in HIV positive migrants from specific regional ‘hotspots’. 

    Of course, the situations in Europe and Australia greatly differ. With strict border controls and compulsory HIV testing when applying for permanent visas, it could be argued that this data does not apply to us – and certainly Australia has some of the lowest rates of HIV positive migration in the world. But there would be few Clinicians among us who do not have patients who have migrated either legally or illegally to this country and there were many elements of this presentation that could be translated into greater awareness and care for this cohort.

    Continue reading…

  • Approaches towards a cure for HIV

    A report on Sarah Fidler's presentation "Approaches towards a cure for HIV"

    This presentation, on the third day of the conference was one of the best attended - with an entirely packed auditorium. As a Clinical Trials Coordinator, the question of a cure comes up on a regular basis in my work. Even though we now have U=U, and with most patients having a very small burden, there are still those who yearn to be pill and disease free.

    Continue reading…