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Beyond viral suppression: the quality of life of people living with HIV in Sweden / EATG Aging/HIV Call To Action: 'Beyond Viral Suppression'
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Reported by Jules Levin
9th IAS Conference on HIV Science (IAS 2017), July 23-26, 2017, Paris
G. Zeluf1, L.E. Eriksson1,, L. Nilunger Mannheimer2, C. Deogan2, L. Nilsson Schonnesson1, A.M
1 Karolinska Institutet, Sweden 2 The Public Health Agency of Sweden. Ekstrom1
"Health systems everywhere need to become more integrated and more people-centered to successfully meet the needs of virally suppressed PLHIV.....The WHO strategy calls for person-centered chronic care for people living with HIV (PLHIV), implicitly acknowledging that viral suppression is not the ultimate goal of treatment. However, it stops short of providing an explicit target for health-related quality of life. It thus fails to take into account the needs of PLHIV who have achieved viral suppression but still must contend with other intense challenges such as serious non-communicable diseases, depression, anxiety, financial stress, and experiences of or apprehension about HIV-related discrimination. We propose adding a 'fourth 90' to the testing and treatment target: ensure that 90% of people with viral load suppression have good health-related quality of life. The new target would expand the continuum-of-services paradigm beyond the existing endpoint of viral suppression. Good health-related quality of life for PLHIV entails attention to two domains: comorbidities and self-perceived quality of life."
EATG >> A CALL TO ACTION BY THE BEYOND VIRAL SUPPRESSION
INITIATIVE.....http://www.eatg.org/news/a-call-to-action-by-thebeyondviral-suppression-initiative/
The Beyond Viral Suppression initiative arises out of a shared recognition among leading HIV experts that there are crucially important issues relating to the health and social inclusion of PLHIV that have to date received insufficient attention from policy makers and healthcare providers, and which must now form part of our HIV response.....In an era when ageing populations and health system sustainability are central challenges for all European countries, the initiative will also aim to inform debates about cost-effective strategies for co-morbidity prevention and management, whilst ensuring patient-centred healthcare delivery. Our recommendations should therefore be of high relevance both to policy makers and the wider health community......The initiative is developing a performance assessment of HIV services 'beyond viral suppression' - focusing on: i. access to appropriate health services; ii. health outcomes - co-morbidity and coinfection prevention, and health-related quality of life; and iii. social outcomes.
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Reported by Jules Levin
9th IAS Conference on HIV Science (IAS 2017), July 23-26, 2017, Paris
G. Zeluf1, L.E. Eriksson1,, L. Nilunger Mannheimer2, C. Deogan2, L. Nilsson Schonnesson1, A.M
1 Karolinska Institutet, Sweden 2 The Public Health Agency of Sweden. Ekstrom1
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Beyond viral suppression of HIV - the new quality of life frontier
Published: 22June2016
https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-016-0640-4
Jeffrey V. Lazarus1,2*, Kelly Safreed-Harmon2, Simon E. Barton3, Dominique Costagliola4, Nikos Dedes5,
Julia del Amo Valero6, Jose M. Gatell7, Ricardo Baptista-Leite8,9, Luís Mendão5, Kholoud Porter10,
Stefano Vella11 and Jurgen Kurt Rockstroh12
Discussion
The WHO strategy calls for person-centered chronic care for people living with HIV (PLHIV), implicitly acknowledging that viral suppression is not the ultimate goal of treatment. However, it stops short of providing an explicit target for health-related quality of life. It thus fails to take into account the needs of PLHIV who have achieved viral suppression but still must contend with other intense challenges such as serious non-communicable diseases, depression, anxiety, financial stress, and experiences of or apprehension about HIV-related discrimination. We propose adding a 'fourth 90' to the testing and treatment target: ensure that 90% of people with viral load suppression have good health-related quality of life. The new target would expand the continuum-of-services paradigm beyond the existing endpoint of viral suppression. Good health-related quality of life for PLHIV entails attention to two domains: comorbidities and self-perceived quality of life.
Conclusions
Health systems everywhere need to become more integrated and more people-centered to successfully meet the needs of virally suppressed PLHIV. By doing so, these systems can better meet the needs of all of their constituents - regardless of HIV status - in an era when many populations worldwide are living much longer with multiple comorbidities.
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