Shm monitoring of hiv in the netherlands
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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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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

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


Actual practice

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


Stakeholders

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


Shm monitoring of hiv in the netherlands

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


Data collection 5 steps

Data collection: 5 steps


Step 1 registration and entry

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


Step 2 monitoring id code or m number

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


Step 3 collection of patient data

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


Step 4 data quality control

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


Step 5 data preparation and analysis

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


Computerisation

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


Analysis and reporting

Analysis and Reporting


Individual patient reporting

Individual patient reporting


Reporting per treatment centre

Reporting per Treatment Centre


National reporting

National Reporting


International reporting

International Reporting


International reporting1

International Reporting

2011: 40 papers


Results

Results


Cascade of hiv care

Cascade of HIV care


Effect of antiretroviral treatment of people with hiv

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


Effect of treatment on the course of the hiv epidemic

Effect of treatment on the course of the HIV epidemic

status quoN=1470

immediate cARTN=917

annual testingN=629

reduced riskN=139

Bezemer et al, AIDS (2008); Van Sighem et al (2011)


Effect of prep on the number of new hiv infections

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)


Increasing plasma hiv rna over time

Increasing plasma HIV-RNA over time


New hcv diagnoses amongst hiv infected patients

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)


Conclusions

Conclusions


Hiv monitoring is a must

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


Shm monitoring of hiv in the netherlands

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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