ASHM Report Back

Clinical posts from members and guests of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) from various international medical and scientific conferences on HIV, AIDS, viral hepatitis, and sexual health.

Duc Nguyen

Duc Nguyen

Duc Nguyen is a Program Manager for ASHM International Division. He has been involved in the ASHM International HIV Program since 2008 and has been supporting the ASHM partnership and collaboration programs in Vietnam, Indonesia, and Timor Leste. Duc has also coordinated the ASHM International Short Course in HIV Medicine since 2008, which aims to advance clinical capacity of regional clinicians in HIV care and management. He also coordinates publication of a regional HIV resource ‘Is It HIV?’, which aims to facilitate early detection of HIV and related conditions, especially at primary health care levels in resource-limited settings. He is also involved in coordinating the ASHM twinning program which involves twinning up HIV professionals from Thailand, Indonesia, Malaysia, and the Philippines with Australia-based clinicians for clinical placements and mentoring support.

While vaccination offers hope for a large decrease in hepatitis B (HBV) in the future, many people today are co-infected with HIV and HBV, particularly in regions where both diseases are common.

Gail Matthews from the Kirby Institute in her presentation today described a huge global burden of disease attributed to HIV and HBV and HIV/HBV co-infection. Discussing the management of HIV/HBV co-infection, Gail Matthews noted that HBV co-infection presents unique challenges, especially in resource-limited settings.

Lack of access to routine testing and monitoring is described as one of the major challenges, which include:

  • limited access to HBsAg testing, which means many co-infected individuals not identified pre-ART;
  • little understanding of natural history of co-infection; liver disease fibrosis assessment not readily available;
  • widespread absence of virological monitoring by HBV DNA testing.

Restricted access to Tenofovir in low and middle income countries, lack of routine screening of pregnant women for HBV and low coverage of universal infant vaccination in many countries are also described as the major challenges to the management of HIV/HBV co-infection.

Gail Matthews advocated for the changes at many levels including policy/advocacy, epidemiology, basic science and clinical research in order to overcome those challenges. These include: improved access to drugs; national testing policies; universal and birth dose vaccination; understanding of natural history of co-infection; management and incidence of flare; options for switch of treatment; and cure strategies.   

 

Tagged in: AIDS 2014 IAS2014

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