16th International AIDS Conference Toronto, Canada - August 13 - 18, 2006

REDUCING HIV/HEPATITIS CO-INFECTION IN EUROPE

Int Conf AIDS. 2006 Aug 13-18;16 Abstract No. WeAx0105

Eramova I.¹, Munz M.¹, Salmon D.², Malkin J.-E.^3
1 WHO Regional Office for Europe, STI and HIV/AIDS Programme, Copenhagen, Denmark, ² Hospital Cochin, Service de Medicine Interne, Paris, France, ³ Esther, Paris, France

ISSUES: HIV/hepatitis co-infection in Europe; WHO European clinical protocols on the management of people living with HIV/AIDS (PLWHA) co-infected with hepatitis B (HBV) or C (HCV).

DESCRIPTION: The increasing availability of highly active antiretroviral therapy (HAART) throughout Europe and central Asia has required a revising of co-morbidity and mortality patterns among PLWHA, as mortality due to liver disease has increasingly replaced AIDS as a major cause of death in PLWHA. The average prevalence of HCV among this group is 40%, and even higher in the countries where the HIV epidemic has been driven by injecting drug use. Access to hepatitis treatment in PLWHA in Europe is still limited, in part due to a lack of clear guidance on the clinical management of HIV/hepatitis co-infections. Since May 2005, the WHO Regional Office for Europe has been developing two European protocols on the clinical management of HIV/HCV and HIV/HBV co-infections, an issue previously not addressed by WHO. The purpose is to provide specific guidance for clinicians. The protocols provide diagnostic algorithms depending on the availability of the resources, and clinical management guidance of co-infected patients who do not need any treatment yet, for those who need only hepatitis or only HIV/AIDS treatment, and for those who need both.

LESSONS LEARNED: Clinical protocols on the management of hepatitis and HIV co-infection, as part of a set of 13 WHO European clinical protocols on HIV/AIDS treatment and care, published in both English and Russian, will serve as a background normative document for developing national guidelines.

RECOMMENDATIONS: After the protocols, the next steps should include increasing access to the prevention and treatment of hepatitis by raising awareness of hepatitis morbidity as a public health issue, through the development of a price reduction strategy for anti-hepatitis drugs and diagnostics, and increasing access to the HBV vaccination.

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2006-08-13
WeAx0105

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