Hiv Optimising treatment for naive patients

Summary


 Asymptomatic (HIV tests)



 HIV-related new presentation


 

 Seroconversion illness

  HIV screening programmes / insurance medicals

 

 Oncology

 

 Medical in-patients

  General practice / dentist / private clinics

 

 Hepatology

 

 Emergency care

  GUM / sexual health clinic

 

 Dermatology

 

 

  Antenatal clinics

 

 TB centres

 

 

  Blood transfusion centres

 

 

 

 

   Addiction treatment

 

 

 

 





Since start of ART, increasing survival rates for people with HIV

Estimated survival for HIV patients from age 25 yearsHepatitis C coinfected patients excluded




Adapted from Lohse N et al. 16th IAC 2006, Toronto, Canada. Abstract MOPE0310 







Decisions made when starting therapy need to be individualised





Starting therapy vs. deferring therapy


 Deferring Therapy

Starting Therapy

 Avoid negative effects on QoL

 Earlier suppression of viral replication

 Avoid drug-related toxicities

 Preserve immune function

 Preserve treatment options

 Prolong disease-free survival

Delay development of resistance

 Lower risk of detrimental viral evolution

Time for patient to understand treatment demands Possible decrease in the risk of HIV transmission

Less chance of treatment fatigue