Conference report: SHM at IWHOD

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The 22nd International Workshop on HIV and Hepatitis Observational Databases (IWHOD) took place in Fuengirola, Spain, from 22 to 24 March.  IWHOD is a closed workshop that aims to bring HIV and hepatitis observational database researchers together to advance the methodology and analysis of observational data. As in previous years, data from Stichting HIV Monitoring’s ATHENA cohort contributed to several oral and poster presentations at the meeting.

SHM researchers, Ard van Sighem and Colette Smit each gave an oral presentation. Ard van Sighem’s talk focussed on the early diagnosis of HIV following a campaign launched in August 2015 as part of the HIV Transmission Elimination AMsterdam (H-TEAM) initiative to promote earlier HIV testing and treatment in Amsterdam. The results showed that, in 2016, homosexual men in Amsterdam were being diagnosed earlier with HIV than in the rest of the Netherlands, suggesting that the H-TEAM’s combined efforts to increase HIV testing and diagnosis at early stages of the infection may be effective.

In her talk, Colette Smit presented data from a study on the uptake of the new direct-acting antiviral agents (DAAs) for the treatment of hepatitis C virus (HCV) infection. This study showed that the broad availability of these agents has led to a rapid uptake of treatment with DAAs. Of those people in the Netherlands ever diagnosed with an HIV/HCV co-infection, more than 80% now no longer have signs of an active HCV infection. However, uptake of HCV treatment is lagging in people less effectively treated for HIV treatment and in people who are prescribed several co-medications.

HCV infection was also the topic of a poster presented by a third SHM researcher, Sonia Boender. Sonia’s poster showed the results of a capture-recapture analysis carried out by linking two national registration databases in the Netherlands, namely the ATHENA cohort database and the national registration of notifiable infectious diseases maintained by the Dutch National Institute for Public Health and the Environment (RIVM). Using this approach, Sonia was able to estimate the number of people living with HIV who had an acute HCV infection between 2013-2016.

Virological failure
A second poster presented by Sonia Boender mapped the incidence of virological failure since the introduction of effective HIV treatment in 1996. Although the risk of virological failure has declined rapidly over time, the study concluded that particular attention should still be paid to specific groups, including women and heterosexual men, people who present  late for care after acquiring HIV, and people originating from sub-Saharan Africa.

Continuum of care in young people
In addition, Colette Smit presented a poster on the HIV continuum of care for individuals who were diagnosed with HIV before the age of 18. On 31 December 2016, 54% of this group were 18 years old or above. The continuum of care showed that viral suppression was lower in young people over 18 years of age than in children below 18 years of age.

Other presentations
Data from the ATHENA cohort contributed to two other posters presented at the workshop. One of these posters, presented by Sebastiaan Verboeket from the AGEhIV study, looked at lung function in people with well-treated HIV. In the second poster, Anders Boyd presented work carried out in collaboration with the MOSAIC study into the long-term patterns of the liver fibrosis marker Fib 4 following acute HCV infection.  

Finally, data from the ATHENA cohort contributed to an additional seven presentations from international collaborations.