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SHM: Monitoring of HIV in the Netherlands

SHM: Monitoring of HIV in the Netherlands. Frank de Wolf, Ard van Sighem. Aim Data collection Analysis en reporting Results Conclusions. Aim SHM. Contribute to knowledge of HIV in the Netherlands through study of: The course of infection in people with HIV

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SHM: Monitoring of HIV in the Netherlands

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  1. SHM: Monitoring of HIV in the Netherlands Frank de Wolf, Ard van Sighem • Aim • Data collection • Analysis en reporting • Results • Conclusions

  2. Aim SHM • Contribute to knowledge of HIV in the Netherlands through study of: • The course of infection in people with HIV • The effect of treatment of people with HIV

  3. Actual practice • Contribute to knowledge of HIV in the Netherlands through study of: • The course of infection in people with HIV • The effect of treatment of people with HIV • We monitor the treatment of each and every man or woman with HIV in the Netherlands • We map out the HIV epidemic in the Netherlands

  4. Stakeholders • Contribute to knowledge of HIV in the Netherlands through study of: • The course of infection in people with HIV • The effect of treatment of people with HIV • We monitor the treatment of each and every man or woman with HIV in the Netherlands • We map out the HIV epidemic in the Netherlands • Individuals with HIV • Treating physicians • HIV care policy makers • HIV researchers

  5. How Per HIV Treatment Centre: • Collection of data from all people with HIV in care • In collaboration with the HIV-treating physician, who supervises the actual collection of data from patients for whom he provides HIV care • 26 hospitals throughout the country are acknowledged by the Ministry of Health as HIV treatment Centre

  6. Data collection: 5 steps

  7. Routine patient care Data collection & QC Data storage & analysis Enrolment- /discontinuation form Treating physician SHM enrolment database Patient Patient’s medical file Material Other laboratories Clinical laboratories Diagnostic procedures Step 1: Registration and Entry

  8. Routine patient care Data collection & QC Data storage & analysis Enrolment- /discontinuation form Fax: ID code = ‘M-number’ Treating physician SHM enrolment database Patient National SHM database Patient’s medical file Data collectors Material Other laboratories Clinical laboratories Diagnostic procedures Step 2: Monitoring ID code or M number

  9. Routine patient care Data collection & QC Data storage & analysis Enrolment- /discontinuation form Fax: ID code = ‘M-number’ Treating physician SHM enrolment database Patient National SHM database Patient’s medical file Data collectors Material Other laboratories Clinical laboratories Diagnostic procedures Step 3: Collection of patient data

  10. Routine patient care Data collection & QC Data storage & analysis Enrolment- /discontinuation form Fax: ID code = ‘M-number’ Treating physician SHM enrolment database Patient National SHM database Patient’s medical file Data collectors Material Data monitors Other laboratories Clinical laboratories Diagnostic procedures Step 4: Data Quality Control

  11. Routine patient care Data collection & QC Data storage & analysis Enrolment- /discontinuation form Fax: ID code = ‘M-number’ Treating physician SHM enrolment database Patient National SHM database Patient’s medical file Data collectors Material Data monitors Analysis Discrepancies Other laboratories Clinical laboratories Diagnostic procedures SHM researchers Monitoring Report & Research output Step 5: Data preparation and analysis

  12. Routine patient care Data collection & QC Data storage & analysis Enrolment- /discontinuation form Fax: ID code = ‘M-number’ Treating physician SHM enrolment database Patient National SHM database Patient’s medical file Data collectors Material Data monitors Analysis Discrepancies Other laboratories Clinical laboratories Diagnostic procedures SHM researchers Monitoring Report & Research output Computerisation

  13. Analysis and Reporting

  14. Individual patient reporting

  15. Reporting per Treatment Centre

  16. National Reporting

  17. International Reporting

  18. International Reporting 2011: 40 papers

  19. Results

  20. Cascade of HIV care

  21. Effect of antiretroviral treatment of people with HIV Gras L, et al; J Acquir Immune Defic Syndr 45 ( 2) 2007 Gras L, et al; Monitoring Report 2011, Stichting HIV Monitoring, Amsterdam, November 2011

  22. Effect of treatment on the course of the HIV epidemic status quo N=1470 immediate cART N=917 annual testing N=629 reduced risk N=139 Bezemer et al, AIDS (2008); Van Sighem et al (2011)

  23. Effect of PrEP on the number of new HIV infections 28% 33% 45% 46% # infections 2010-2019 No PrEP New MSM All MSM 5% All MSM 10% New MSM + 5% all MSM Van Sighem A, et al. State of the cART (2012)

  24. Increasing plasma HIV-RNA over time

  25. New HCV diagnoses amongst HIV-infected patients • Increase in HCV testing • Increase in number HCV positives with a last HCV negative test result • Percentage positive declined to 4% per year • Percentages tested positive for HCV declined (stratified by risk group) Smit C, et al. AIGHD HCV Symposium (2012)

  26. Conclusions

  27. HIV monitoring is a must • HIV Monitoring is crucial for assessing the quality of care for people with HIV, including the effect of antiretroviral treatment and the development of resistance • HIV monitoring is needed for our understanding of the changes in the HIV epidemic • Mandatory collection of anonymised patient data is essential for HIV monitoring

  28. Patient data collection and QC Manager: Sima Zaheri Patient Registration: Rosalind Beard Data Collection: Mieke van den Akker, Yvonne Bakker, Marjo Broekhoven-van Kruijne, Els Claessen, Chantal Deurloo-van Wanrooij, Leonie de Groot-Berndsen, Carla Lodewijk, Brid Peeck, Yolanda Ruijs-Tiggelman, Els Tuijn-de Bruin, Lia Veenenberg-Benschop, Tieme Woudstra. Data Monitoring & QC: Marieke Berkhout, Rosalie van den Boogaard, Shula Grivell, Mariska Hillebregt, Pytsje Hoekstra, Anna Jansen, Viola Kimmel, Anna de Lang, Bianca Slieker, Nynke Wijnstok Data preparation and analysis Head:Frank de Wolf Research staff:Daniela Bezemer, Luuk Gras, Ard van Sighem, Colette Smit, Rebecca Holman Anouk Kesselring, PhD students: Esther Engelhard, Gonneke Hermanides, Rob van den Hengel Office, Administration, Communication Manager: Danielle de Boer Office: Mireille Koenen, Inge Bartels Administration: Irene de Boer, Henk van Noort Communication: Louise Dolfing-Tompson, Anneke Nollen Director Frank de Wolf SHM

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