While the USA has seen increasing rates of acute hepatitis B and hepatitis C, as well as increasing cases of HIV linked to injecting drug use, other parts of the world such as Australia are on track to eliminate hepatitis C.
This presentation summarised the latest data on life expectancy and the co-morbidities that are seen in people living with HIV and considered whether life expectancy has now ‘normalised’ in comparison with that of the HIV-negative population, drawing attention to the possible methodological biases and important subsets in whom life expectancy remains substantially shorter than desired.
PrEP is effective in reducing recent HIV infections on a population state-wide level. More work is required to target harder-to-reach groups as PrEP was less effective in these groups in reducing recent HIV infections.
Population-wide interventions/health-service design can reduce the time it takes from HIV diagnosis to first virologic suppression and the consequent population health benefits. In the RAPID program, 30% of patients commenced treatment within 5 days (2016) compared to 6% (2013). The time to virological suppression reduced from 134 days (2013) to 61 days (2016). Median days to virological suppression was 43-61 days in 2016.
There are many structural and other barriers which may prevent patients accessing care. Re-linking individuals to the same system of care that failed to engage them in the first place is not an effective strategy. For the hardest-to-reach patients, we need to change the structure of care available.
Bictegravir in a single-tablet regimen, which can be dosed without food, will become another treatment option available to HIV prescribers. It is safe and effective to switch patients from Dolutegravir/Abacavir/3TC.