July/Aug 2015: Volume 16 Number 7/8

HTB JulAuyg 2015 coverThis is an exciting and important time for HIV care.

This issue of HTB includes reports from the IAS 2015 conference in Vancouver where new studies on treatment and prevention will change HIV guidelines and programmes worldwide.

These developments are covered in a range of articles that support a radical change in our approach to managing HIV. One such example is that the option to start treatment promptly becomes the routine next step after someone finds out that they are HIV positive.

This does not mean losing the wealth of experience that led to the current multidisciplinary model of care. It means focusing that experience so that some aspects of this approach do not become a barrier to treatment.

The San Fransicso model presented at IAS 2015, in what might be seen as a hard to treat population, showed that the option for same day ART could be expanded in the UK to more than just the few clinics here that currently focus on treating primary HIV infection.

IAS 2015 did not just have implications for the UK but for global health, for which setting the UNAIDS 2014 targets of 90-90-90 produces not just a way to measure how well a country is responding to HIV, but provides a framework for dramatically reducing new infections, even within five years.

This approach involves not just early treatment, but better treatment, better testing and better prevention that includes PrEP.

The draft 2015 BHIVA guidelines, reported later in this issue of HTB, reflect the most significant changes in HIV care and treatment strategies for at least a decade.

Other reports from IAS include notice that WHO 2015 guidelines will similarly recommend ART for all irrespective of CD4 count.

The 90-90-90 targets mean by 2020, 90% of all HIV positive people will know their status, 90% of all people with diagnosed HIV will receive ART and 90% of all people receiving ART will have viral suppression. Many of the developments reported at IAS 2015 – which we cover in this and the next issue – will contribute towards these ambitious goals.

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