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The initiative aims to tackle HIV-related health challenges faced by people living with HIV (PLWHIV), such as associated mental and physical co-morbidities, mental health issues, financial stresses and potential HIV-related stigma. The launch took place at the 17th European AIDS Conference 2019.
Recommendations in the white paper, which have been summarised in AIDS Reviews,focus on a new HIV care framework – Health Goals for Me. The recommendations were developed to support an holistic and individualised long-term treatment approach that goes beyond viral load and CD4 count, to assess health-related quality of life. Designed to empower healthcare professionals and PLWHIV to collaborate and mutually agree on objectives for care beyond viral suppression, the framework is comprised of a continuous cycle of ‘ask and measure’, ‘feedback and discussion’, and ‘intervention’.
“It is a pivotal moment in HIV,” said Dr Giovanni Guaraldi, Chair of the Moving Fourth Expert Committee and Associate Professor of Infectious Disease and Head of the Modena HIV Metabolic Clinic (MHMC), Italy, in launching the group’s first paper. “Pioneering research means the disease is now viewed as a chronic condition. However, this brings new challenges relating to long-term health; as increasing numbers of people navigate their lives beyond viral suppression and look towards improved quality of life. Health Goals for Me should become an intrinsic part of HIV care in the future.”
This international, expert alignment represents a pathway to achieving the ‘fourth 90’, a goal that builds on the United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 treatment target. Through Health Goals for Me, the Moving Fourth Expert Committee aims to increase focus on taking an individualised long-term approach to patient care, which forms the basis of our continued work to develop practical tools which can help improve health-related quality of life for PLWHIV.
The UNAIDS proposed the ambitious 90-90-90 treatment plan in 2014 to end the AIDS epidemic: to diagnose 90% of all HIV-positive persons; provide antiretroviral therapy (ART) to 90% of those diagnosed; and to achieve viral suppression for 90% of those treated by 2020. These targets, however, do not cover other HIV-related health challenges faced by people living with HIV.
Mario Cascio, Former-Chair of European AIDS Treatment Group (EATG), Italy, who lives with HIV and is a member of the expert committee said: “Treatment guidelines and policy for HIV are much the same as when it was a fatal disease. Despite HIV being considered a chronic condition, many people are suffering with the day-to-day impact of the disease, such as continued stigma, discrimination and health conditions experienced after many years of living with HIV. This international consensus represents an important first step to improve care beyond viral load and ultimately improve the lives of people living with HIV.”
“The Moving Fourth steering committee was convened to establish a way in which the ‘fourth 90’ can be achieved,” said Allitia diBernardo, Europe, Middle East and Africa Infectious Diseases and Vaccines Therapeutic Area Lead, Janssen-Cilag International NV. “The ultimate aim of this initiative is to provide clear, detailed guidelines and tools that support a holistic, individualised, long-term treatment approach for PLWHIV that goes beyond viral load and CD4 count. At Janssen we recognise that, despite progress made, HIV remains one of the greatest global health threats of our time. We won’t stop until we end HIV.”
The Moving Fourth steering committee members are:
• Dr Giovanni Guaraldi (Chair), Associate Professor of Infectious Disease and Head of the Modena HIV Metabolic Clinic (MHMC), Italy
• Dr Joop Arends, Internist, Associate Professor of Infectious Disease and Infectious Diseases Physician, Department of Internal Medicine and Infectious Diseases, University Medical Centre Utrecht, The Netherlands
• Dr Thomas Buhk, Internist, Infectiologist, Centers for Infectious Diseases in Hamburg (ICH-Hamburg), Germany
• Mario Cascio Former-Chair, European AIDS Treatment Group (EATG), Italy
• Dr Adrian Curran, Internist, Infectious Disease Specialist, Department of Infectious Diseases, Vall d’Hebron University Hospital, Barcelona, Spain
• Dr Eugenio Teofilo, Internist, Department of Internal Medicine at Hospital Dos Capuchos, Lisboa, Portugal
• Dr Guido Van den Berk, Internist, Infectious Disease Specialist, Department of Internal Medicine, OLVG, City Hospital of Greater Amsterdam, The Netherlands
• Christian Verger, Chair of the Grand Est region, Board member, AIDES-France, France