The European AIDS Treatment Group (EATG), held a meeting titled ‘Taskforce meeting: Operationalising Ageing with HIV project R&D Outcomes and identified research gaps’ in Frankfurt, Germany, on 21 of March 2019.
This meeting was the last event organised within the framework of the Ageing with HIV Project – New challenges and unmet needs of people living with HIV/AIDS (2015 – March 2019). The goal was to work on the R&D outcomes and identified research gaps and to define concrete suggestions about future activities (in science/policy & advocacy/training) for the EATG and other community partners. Another key objective was to discuss a new model of integrated care that places PLHIV as equal partners amongst health care professionals and other care providers.
19 participants, EATG members and representatives of other community organisations from various European countries took part in the meeting, which was held in a workshop format and consisted of a group exercise.
While a detailed report will be published later, below are some of the main discussion points from the meeting:
1. HIV and ageing related co-morbidities e.g. neurocognitive impairment, heart disease, frailty, and diabetes.
• The needs of specific populations e.g. transgender people, women after menopause, drug users or chemsex users should be considered.
• Research and clinical trials should also include the elderly PLHIV.
• Long-term impact of HIV and comorbidities in different cohorts must be observed.
• Role of chronic inflammation: markers should be included in clinical trials also to understand which one is most important.
• The role of HIV doctors: Multi-discipline knowledge among younger doctors on long term care of PLWHIV when Ageing is concerned.
2. Monitoring and screening tools targeted for ageing PLWHIV
• Patient Reported Outcomes Measures,(PROMS) needs to be further developed.
• Advanced biomarkers and diagnostic tools are essential.
• Real world data (like wearable devices) can contribute.
• Active review of retention in care could be achieved by automatic monitoring.
• Cross-discipline groups contribute to a patient centered approach.
3. Polypharmacy and ‘pill burden’
• Sharing information between GP, HIV clinician and other specialists is important.
• More research to be done on systems to improve this communication.
• Involvement of patients and treatment literacy are essential.
• Pill burden: The issue is not only about the quantity of pills (how many), but also about the treatment schedule (how often)
4. Drug-drug interactions
• Using https://www.hiv-druginteractio
• Further studies about interactions with recreational drugs
• Inclusion of elderly PLHIV in clinical trials. (e.g. age-related changes in pharmacokinetics affecting absorption of drugs)
• Recommend industry, academia and regulatory agencies for considering ageing issues in research.
• Provide education to community peers.
• Support clinicians to raise new research questions, advocating for more interdisciplinary studies.
5. Preventative measures and Rehabilitation
• Early diagnoses are important to distinguish between those who are already frail and those at risk
• Preventive medicine is not prioritized in clinical practice so community needs to do
• Rehabilitation needs to be part of an integrated model to respond to the needs of the ageing PLWHV population.
• Advocate for an indicator for frailty to work on prevention.
• Recommend rehabilitation standards of care for people living with HIV to be developed by HIV clinicians and geriatrics.
These points, together with the detailed report will be taken on by the European Community Advisory Board (ECAB), and the EATG Training and Capacity Building as well as Policy/Advocacy work as part of the follow up from Ageing with HIV Project.