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HIV remains a major public health issue
Global Impact of HIV/AIDSMore than 35 years since the first cases were reported, HIV/AIDS remains one of the world’s foremost health challenges
36.7MPeople around the
world living with HIV
>18M People still in need
of treatment
2.1MPeople newly infected
with HIV each year
UNAIDS (2016). AIDS by the numbers. UNAIDS Joint United Nations Programme on HIV/AIDS. Available at: http://www.unaids.org/sites/default/files/media_asset/AIDS-by-the-numbers-
2016_en.pdf [Accessed August 2018].
WHY NOW?
• HIV has evolved from a terminal illness to a chronic disease
• PLHIV still experience pre-mature aging
• The focus is now on preserving lifelong good health
3
Lazarus JV, et al. BMC Medicine 2016:14:94
Where ARTs are accessible, the goal has been viral suppression
UNAIDS (2014). 90-90-90 An ambitious treatment target to help end the AIDS epidemic. Joint United Nations Programme on HIV/AIDS (UNAIDS)..Available at: http://www.unaids.org/sites/default/files/media_asset/90-90-90_en.pdf [Accessed September 2018].
4
The future of HIV care focuses on viral
suppression and on helping PLHIV achieve lifelong good health
Lazarus JV, et al. BMC Medicine 2016:14:94
Now there is an expanded vision:viral suppression and lifelong good health
5
A person who goes The Full 360 ‘can relegate HIV to the periphery of their life’1
6
1. Lazarus JV, et al. BMC Medicine 2016:14:942. http://www.hivisjustapartofme.eu/
“HIV is just a part of me because I’ve dealt with it
and it’s not running my life anymore” – Patient2
• PLHIV experience a higher prevalence of co-morbidities including renal failure, bone fractures and diabetes
• The prevalence of co-morbidities among PLHIV was similar to the prevalence in the general population who were 10–15 years older
• PLHIV develop frailty 10 years younger than uninfected individuals
7
The onset of co-morbidities in PLHIV occur ~10 years earlier than in the general population
Guaraldi G, et al. CID 2011;53:1120-6.
Has 50 become the new 60 for PLHIV?
The Vision is Evolving
THE TRADITIONAL VIEW:
HIV
Primary Focus: The virus
Primary Focus:
Viral suppression, with co-morbidities occurring earlier than in the general population
The Vision:
THE NEW VIEW:
PEOPLE LIVING WITH HIV
Primary Focus: The whole person
Primary Focus:
Viral suppression& lifelong good health, with health status similar to the general population
The Vision:
• Improvements in safety profiles for newer ARV therapies
• Prevention of HIV- and ARV-related co-morbidities is preferred to managing them
• HIV physicians have an opportunity to influence HIV treatment choice
• Risk can be monitored but there is no way to predict when and who will develop co-morbidities
Good health can start with controlling what is most controllable – appropriate choice of HIV treatment
Guaraldi G, et al. CID 2011;53:1120-6.
10
The Full 360 is achievable with coordinated efforts
The Full 360 –the next advancement in the treatment and care of PLHIV
The Full 360 - Expand 90-90-90 to include a 4th
dimension of good health
Alignment amongst ALL stakeholders
New Aspiration
Common Vision