HIV and STI Department, Health Protection Agency - Colindale

HIV and AIDS Reporting System

The United Kingdom provides excellent access and quality of HIV care: Results from a national cohort

Valerie Delpech, Zheng Yin, Meaghan Kall & Alison Brown

July 2012

HIV and STI Department, Health Protection Agency - Colindale

HIV and AIDS Reporting System

The HIV epidemic in the UK

• NHS provides free and open access care to HIV and STI patients

• 100,000 living with HIV in 2012 (0.15%)

• Epidemic concentrated in MSM, Africans communities & persons who inject drugs

• 6,500 new diagnoses annually

Estimated number of people living with HIV, UK (MPES)

HIV and STI Department, Health Protection Agency - Colindale

HIV and AIDS Reporting System

HIV Quality of care indicators1. Late HIV diagnosis 2. Prompt integration into care 3. Achieving viral load suppression4. Successful care 5. Survival

Data sources:1. New HIV diagnoses2. Annual surveys of all HIV patients accessing care 3. Longitudinal CD4 counts from laboratory reports.

HIV and STI Department, Health Protection Agency - Colindale

HIV and AIDS Reporting System

Conclusions

• The UK healthcare services provide excellent access and quality of HIV care, regardless of patient demographical characteristics.

• Expanding testing to reduce late diagnosis remains the most important challenge

• data on clinical outcomes should form part of routine surveillance

HIV and STI Department, Health Protection Agency - Colindale

HIV and AIDS Reporting System

Late diagnosis at diagnosis: UK, 2010

HIV and STI Department, Health Protection Agency - Colindale

HIV and AIDS Reporting System

Integration into HIV careFirst CD4 count after HIV diagnosis

by ethnic group: UK, 2010

HIV and STI Department, Health Protection Agency - Colindale

HIV and AIDS Reporting System

Undetectable viral load within one year of ART by exposure group: UK, 2010

HIV and STI Department, Health Protection Agency - Colindale

HIV and AIDS Reporting System

Successful care: CD4 count of adults after 1+ years in HIV care

by exposure group: UK, 2010

HIV and STI Department, Health Protection Agency - Colindale

HIV and AIDS Reporting System

Prompt and late HIV diagnosis in MSM with associated short-term mortality: UK, 2001-

2010

HIV and STI Department, Health Protection Agency - Colindale

HIV and AIDS Reporting System

The treatment cascade among HIV positive people in the UK:2010

* Numbers were adjusted by missing information and rounded to the nearest 100. § Viral load <50 copies/ml after HIV treatment initiation in the year of initiation.

HIV and STI Department, Health Protection Agency - Colindale

HIV and AIDS Reporting System

Acknowledgements• HIV & GUM physicians and all those who

contribute to HIV & STI surveillance• Colleagues at the HIV &STI Department, HPA

HIV and STI Department, Health Protection Agency - Colindale

HIV and AIDS Reporting System

Acknowledgements

The continuing collaboration of clinicians, microbiologists, immunologists, public health practitioners, occupational health doctors and

nurses and other colleagues who contribute to the surveillance of HIV and STIs in the UK