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HIV co-infections: implications for global screening and treatment (WP1340)

Due to the impact of the Ebola response on a number of organisations and governments and subsequent need for them to focus on this current global health challenge, a decision has been taken to postpone this meeting. It is expected to be rescheduled to take place in the first few months of 2015. If you need further advice, please contact Lisa Elvy.

 

Millions of people with HIV/AIDS worldwide are also living with serious concurrent infections, including tuberculosis (TB), hepatitis B and hepatitis C. Most global health experts agree that in conjunction with universal access to ARV therapy, diagnosis and treatment of common HIV, co-infections must become a priority in resource-limited settings. Despite multiple challenges, encouraging progress continues in the development of screening tools and effective drug therapies for these co-infections and in making them widely available to people in need.

At this meeting, individuals who play key roles in increasing access to diagnosis and treatment for major HIV co-infections will meet to discuss progress to date and practical steps needed to accelerate it. We will look at the implications for global screening and treatment of HIV co-infections, including TB, Hepatitis B and Hepatitis C.

A group of about 50 leading policy-makers, scientists, clinicians, program implementers, and advocates will be invited to debate the current frontiers in HIV co-infection with TB, HBV and HCV. Discussion will focus on major scientific advances in screening and therapeutics, as well as approaches to overcoming barriers to access. Participants will share scientific and programmatic expertise, debate critical issues and identify practical ways to rapidly expand access to screening and treatment in heavily impacted communities. The report of the meeting will distil this information and provide a roadmap for further international and local action to aggressively take advantage of the new breakthroughs in diagnosis and treatment.

Tuberculosis

Limited access to TB prevention, screening and effective treatment in resource-limited settings is one reason the disease is the leading cause of death among people living with HIV worldwide. TB accounts for 25 percent of all AIDS deaths, and more in some regions. Today, more than a third of people living with HIV worldwide have active TB infection. Effective treatment for TB exists, but presents challenges. Providers must carefully monitor patients taking TB and ARV therapy together for potential side effects and, to avoid drug resistance, routinely observe patients to ensure they complete treatment. Even in the light of these obstacles, improved access would yield important benefits. According to World Health Organisation (WHO) recommendations, “scaling up TB prevention and treatment alongside ARV access is essential for maximizing the benefits of each intervention, and could result in significant gains in longevity and productivity”.

Viral Hepatitis

Among people living with HIV worldwide, viral hepatitis is widespread. Today, an estimated 10 percent of people with HIV have chronic HBV infection, and approximately 20 percent are estimated to be chronically HCV-infected. HIV can hasten HCV disease progression, increasing the likelihood of liver cirrhosis and liver cancer among infected people. Today, new direct-acting antivirals present an opportunity to treat and cure many more HCV-infected patients – including those co-infected with HIV – in a relatively short time period. For patients with HBV, long-term antiviral therapy can suppress the virus to prevent serious liver disease and be seamlessly integrated with HIV treatment, since key components of WHO-recommended ARV regimens are also effective long-term therapies for HBV. The development of initiatives to scale up access to diagnostics and medicines for HBV and HCV are still underway.

 

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The new era in HIV/AIDS treatment and prevention: science, implementation and finance

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