Date of preparation: October 2018Job bag: HIV/IHQ/18-06//1638s

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

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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].

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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

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A person who goes The Full 360 ‘can relegate HIV to the periphery of their life’1

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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

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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.

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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

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