PRESS RELEASE: the Netherlands is close to meeting 2 out of 3 new UNAIDS HIV treatment targets

17 November 2014

Amsterdam, 17 November - Stichting HIV Monitoring reports that the Netherlands is close to meeting 2 out of 3 new UNAIDS HIV treatment targets.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) has recently set new ambitious HIV treatment targets to curb the global HIV epidemic: by 2020, 90% of all people living with HIV will know their HIV status; 90% of all people with diagnosed HIV infection will receive antiretroviral therapy; and 90% of all people receiving therapy will have viral suppression. The new figures for the Netherlands, published in Stichting HIV Monitoring’s Monitoring Report 2014, show that the Netherlands is already close to achieving the latter two of these three UNAIDS 2020 targets.

Of the approximately 19,000 people with HIV ever linked to care, registered by Stichting HIV Monitoring, still alive and not reported as having moved abroad, 84% receive antiretroviral therapy. Of the 17,750 patients in care at one of the 27 HIV treatment centres in the Netherlands, more than 90% are receiving treatment and more than 90% of the approximately 16,000 patients on cART have very low levels of HIV in their blood.

The remaining target, namely that 90% of people infected with HIV are aware of their HIV status, has not yet been achieved in the Netherlands.

UNAIDS estimates that there are between 20,000 and 34,000 people living with HIV in the Netherlands. Based on a total estimated number of 25,000 people, the figures reported by Stichting HIV Monitoring indicate that 76% of all HIV-infected individuals in the Netherlands know their HIV status. However, the remaining quarter of people with HIV in the Netherlands are likely unaware of their infection and therefore not in care.

This group of as yet undiagnosed individuals is thought to importantly contribute towards sustaining the HIV epidemic in the Netherlands: in 2013, there were once again more than 1000 patients newly diagnosed with HIV. The majority (71%) of these patients were men who have sex with men (MSM), while 23% were persons who had most likely acquired HIV through heterosexual contact.

Achieving the first of the new UNAIDS 90-90-90 targets will require a combined effort by all stakeholders. The approach should combine innovative means to implement more widespread testing, earlier diagnosis and treatment, as well as investigating the use of biomedical prevention strategies, such as pre-exposure and post-exposure prophylaxis, and developing better methods to estimate the number of people living with HIV. Moreover, there is a need for clear communication about the benefits of such an approach amongst both the most at-risk groups and the relevant care providers. The HIV Transmission Elimination Amsterdam (H-TEAM) programme, being developed in Amsterdam by a newly formed multidisciplinary and interdisciplinary consortium of stakeholders which includes SHM and other stakeholders from public health, academia, civil society, the patient organisation, and industry, serves as an example of such an approach.

Novel hepatitis C drugs may prevent hepatitis C transmission in HIV co-infected patients

Of the 1,187 Hepatitis C virus (HCV)/HIV co-infected patients who receive ongoing care in one of the Dutch HIV treatment centres, a total of 907 (76%) still need effective HCV therapy. HCV may more rapidly lead to severe liver disease and liver cancer in these patients compared to in patients without HIV infection. Although rarely seen in men who have sex with men (MSM) without HIV, in the Netherlands sexual transmission of HCV has become an important mode of HCV acquisition among HIV-infected MSM.

The imminent availability of novel, better tolerated all-oral combination antiviral regimens against HCV, which may achieve cure rates in over 90 percent of patients, is eagerly awaited. The first of these agents, sofosbuvir, has very recently been granted approval in the Netherlands for use in a subgroup of patients with chronic hepatitis C infection and in urgent need of treatment. The approval of additional new anti-HCV drugs is expected to follow shortly.   

Extending the indication for use of these highly effective combination regimens to all HIV-infected patients with HCV is highly important, not only to improve individual health outcomes, but also because it may importantly contribute to preventing onward transmission of HCV. 

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