Provides information on management of syphilis in patients with HIV, including clinical recommendations and key points regarding transmission, prevention, screening, treatment, follow-up, and partner exposure.
Find more information at https://www.hivguidelines.org/sti-care/syphilis/
Sponsored by the New York State Department of Health (NYSDOH) AIDS Institute (AI) and the HIV Clinical Guidelines Program
Provides information on diagnosis and management of HIV-2 in adults, including an overview of HIV-2 and clinical recommendations and key points regarding diagnosis and treatment of HIV-2, monitoring antiretroviral therapy (ART), pregnancy, and pre- and post-exposure prophylaxis (PrEP and PEP).
Find more information at https://www.hivguidelines.org/hiv-testing-acute-infection/hiv-2/
Sponsored by the New York State Department of Health (NYSDOH) AIDS Institute (AI) and the HIV Clinical Guidelines Program
2. Delia Geary IDPS lab workshop march 2019PHEScreening
This document discusses the process of incorporating Public Health England's antenatal and newborn screening standards into UKAS accreditation to ISO 15189 for laboratories performing infectious diseases in pregnancy screening. The objectives are to reduce assessment burden, improve communication and patient safety through a coordinated accreditation and quality assurance process. PHE screening requirements have been mapped to ISO 15189. Laboratories must meet both PHE and ISO standards to receive and maintain accreditation, with information sharing between UKAS and PHE's quality assurance program. The process aims to strengthen oversight of screening laboratories while minimizing duplicate efforts.
4. Samir Dervisevic hepatitis b antenatal screening algorithms and reportingPHEScreening
This document discusses hepatitis B screening algorithms and reporting for pregnant women in the UK. It provides background on the national screening program and standards for viral hepatitis B screening during pregnancy. The goals of antenatal hepatitis B screening are early detection of infection to enable treatment for the mother and reduce mother-to-child transmission risk by offering newborn vaccination and prophylaxis. The document reviews epidemiology data on acute hepatitis B cases in Europe and England and outlines the clinical outcome and diagnosis of hepatitis B infection through various serological markers. It presents the hepatitis B testing algorithm and provides clinical comments for reporting screening test results.
The document provides an overview of Integrated Counselling and Testing Centres (ICTCs) in India. ICTCs were established in 2006 by integrating Voluntary Counselling and Testing Centres (VCTCs) and facilities providing Prevention of Parent to Child Transmission of HIV/AIDS (PPTCT) services. ICTCs provide HIV counseling, testing, and linkage to care services. They play a key role in HIV prevention, diagnosis, and treatment initiatives like PPTCT. The document outlines the functions, infrastructure, staffing, testing strategies and protocols of ICTCs in India.
The UK Imported Fever Service (IFS) plays a key role in managing unwell travelers returning from areas affected by disease outbreaks like the 2014 Ebola outbreak. The IFS provides 24/7 clinical and infection control advice, conducts diagnostic testing for viruses like Ebola, and assists with public health responses. During the 2014 Ebola outbreak, the IFS saw a large increase in calls and conducted over 70 virus screening tests, identifying one returned healthcare worker with Ebola. The IFS acts as a national surveillance system and point of contact for virus threats imported into the UK.
1) Immediate diagnosis and treatment of acute HIV infection is essential to improve patient outcomes and reduce transmission. Clinicians should consider acute HIV in patients with nonspecific flu-like symptoms and test with HIV RNA and antigen/antibody tests.
2) If HIV RNA is detected at ≥5,000 copies/mL, acute HIV infection should be presumed even if antibody tests are negative or indeterminate, and ART initiated immediately.
3) All patients diagnosed with acute HIV should be linked to experienced providers, offered partner notification assistance, and counseled on the increased risk of transmission during acute infection. Rapid ART initiation can reduce further transmission and illness.
This document provides guidelines for conducting population-based surveys to measure national HIV prevalence. It outlines how to plan and implement a new national survey, incorporate HIV testing into existing surveys, and calculate a national HIV prevalence estimate by combining data from surveys and sentinel surveillance. Population-based surveys can provide more representative HIV prevalence data than sentinel surveillance alone. The guidelines aim to help countries obtain accurate national estimates by adjusting prevalence measures from different data sources and accounting for biases.
Provides information on diagnosis and management of HIV-2 in adults, including an overview of HIV-2 and clinical recommendations and key points regarding diagnosis and treatment of HIV-2, monitoring antiretroviral therapy (ART), pregnancy, and pre- and post-exposure prophylaxis (PrEP and PEP).
Find more information at https://www.hivguidelines.org/hiv-testing-acute-infection/hiv-2/
Sponsored by the New York State Department of Health (NYSDOH) AIDS Institute (AI) and the HIV Clinical Guidelines Program
2. Delia Geary IDPS lab workshop march 2019PHEScreening
This document discusses the process of incorporating Public Health England's antenatal and newborn screening standards into UKAS accreditation to ISO 15189 for laboratories performing infectious diseases in pregnancy screening. The objectives are to reduce assessment burden, improve communication and patient safety through a coordinated accreditation and quality assurance process. PHE screening requirements have been mapped to ISO 15189. Laboratories must meet both PHE and ISO standards to receive and maintain accreditation, with information sharing between UKAS and PHE's quality assurance program. The process aims to strengthen oversight of screening laboratories while minimizing duplicate efforts.
4. Samir Dervisevic hepatitis b antenatal screening algorithms and reportingPHEScreening
This document discusses hepatitis B screening algorithms and reporting for pregnant women in the UK. It provides background on the national screening program and standards for viral hepatitis B screening during pregnancy. The goals of antenatal hepatitis B screening are early detection of infection to enable treatment for the mother and reduce mother-to-child transmission risk by offering newborn vaccination and prophylaxis. The document reviews epidemiology data on acute hepatitis B cases in Europe and England and outlines the clinical outcome and diagnosis of hepatitis B infection through various serological markers. It presents the hepatitis B testing algorithm and provides clinical comments for reporting screening test results.
The document provides an overview of Integrated Counselling and Testing Centres (ICTCs) in India. ICTCs were established in 2006 by integrating Voluntary Counselling and Testing Centres (VCTCs) and facilities providing Prevention of Parent to Child Transmission of HIV/AIDS (PPTCT) services. ICTCs provide HIV counseling, testing, and linkage to care services. They play a key role in HIV prevention, diagnosis, and treatment initiatives like PPTCT. The document outlines the functions, infrastructure, staffing, testing strategies and protocols of ICTCs in India.
The UK Imported Fever Service (IFS) plays a key role in managing unwell travelers returning from areas affected by disease outbreaks like the 2014 Ebola outbreak. The IFS provides 24/7 clinical and infection control advice, conducts diagnostic testing for viruses like Ebola, and assists with public health responses. During the 2014 Ebola outbreak, the IFS saw a large increase in calls and conducted over 70 virus screening tests, identifying one returned healthcare worker with Ebola. The IFS acts as a national surveillance system and point of contact for virus threats imported into the UK.
1) Immediate diagnosis and treatment of acute HIV infection is essential to improve patient outcomes and reduce transmission. Clinicians should consider acute HIV in patients with nonspecific flu-like symptoms and test with HIV RNA and antigen/antibody tests.
2) If HIV RNA is detected at ≥5,000 copies/mL, acute HIV infection should be presumed even if antibody tests are negative or indeterminate, and ART initiated immediately.
3) All patients diagnosed with acute HIV should be linked to experienced providers, offered partner notification assistance, and counseled on the increased risk of transmission during acute infection. Rapid ART initiation can reduce further transmission and illness.
This document provides guidelines for conducting population-based surveys to measure national HIV prevalence. It outlines how to plan and implement a new national survey, incorporate HIV testing into existing surveys, and calculate a national HIV prevalence estimate by combining data from surveys and sentinel surveillance. Population-based surveys can provide more representative HIV prevalence data than sentinel surveillance alone. The guidelines aim to help countries obtain accurate national estimates by adjusting prevalence measures from different data sources and accounting for biases.
Fast-track the end of AIDS in the EU - practical evidence-based interventions.
Presentation by: Valerie Delpech, Public Health Engand
In a two-day meeting under the auspices of the Maltese Presidency of the Council of the European Union (30-31 January 2017), HIV experts from across the European Union discussed how to reverse this trend and how to prepare Europe to achieve the set target of ending AIDS by 2030.
The document provides guidelines for healthcare providers in New York State on pre-exposure prophylaxis (PrEP) for HIV prevention. It recommends that PrEP with tenofovir/emtricitabine should be offered to individuals at high risk of acquiring HIV. PrEP has been shown to be over 90% effective in reducing HIV risk when taken daily as prescribed, but requires adherence to daily dosing and regular medical monitoring including HIV and STI testing every 3 months. The guidelines provide recommendations on candidate selection, counseling, prescribing and follow up care for individuals on PrEP.
The document discusses metrics for monitoring the cascade of HIV services across the continuum of care. It presents a conceptual framework showing the cascade from diagnosis to viral suppression. Key metrics are identified to measure progress at each stage, including the percentage of people living with HIV who know their status, are linked to care, initiated on antiretroviral therapy, and have achieved viral suppression. The metrics were field tested in two countries and found useful for program assessment. Challenges include data quality and capacity at the local level. Guidelines will be published in early 2014 to help countries use these metrics to identify gaps and improve program performance.
The document discusses training nurses to care for patients during epidemics and pandemics. It emphasizes the importance of infection control practices like universal precautions, proper sanitation, and use of personal protective equipment. Hospitals need emergency response plans that include staff education, isolation protocols, environmental cleaning, and collaborating with public health authorities during infectious disease outbreaks. Primary healthcare is a priority that needs to be strengthened to improve preparedness and response to future health crises.
This document provides an overview of infection control in healthcare settings. It defines healthcare-associated infections and outlines some of the major reasons they are rising in hospitals, such as advancing patient age and increased antibiotic resistance. Consequences of healthcare-associated infections include increased morbidity, prolonged hospitalization, increased costs, and death. Effective infection control requires surveillance, monitoring, investigation of potential outbreaks, management to interrupt outbreaks, and staff training. New technologies like antimicrobial surfaces and UV light are showing promise in reducing healthcare-associated infections. Ongoing challenges include decreasing funds, increasing drug resistance, and ensuring adequate physician leadership and engagement in quality improvement efforts.
Optimal HIV testing strategies to achieve high levels of HIV diagnosis in Sou...Carmen Figueroa
This document discusses optimal HIV testing strategies to achieve high levels of HIV diagnosis in South Africa. It summarizes that while South Africa has made progress towards diagnosing 90% of HIV cases by 2020, testing gaps remain, particularly for men, youth, and key populations. The document outlines using an agent-based model to assess the efficiency and cost-effectiveness of various testing strategies, such as home-based testing, mobile testing, and targeted testing of sex workers and partners of diagnosed individuals. Preliminary findings suggest strategies like assisted partner notification and testing sex workers and men who have sex with men could be highly cost-effective in increasing diagnoses and reducing undiagnosed cases.
Cost of testing per new HIV diagnosis as a metric for monitoring cost-effecti...Carmen Figueroa
This document analyzes the cost-effectiveness of additional HIV testing programs in southern Africa beyond core testing through mathematical modeling. It finds that using the cost-per-new-HIV-diagnosis as a metric, additional testing programs for men are likely cost-effective if the cost is below $585 per diagnosis. However, additional testing programs for women are unlikely to be cost-effective. The analysis is based on simulating 1000 scenarios of HIV epidemics and testing programs in southern Africa to examine outcomes and costs over 50 years.
Public health surveillance involves the continuous collection and analysis of health data to support public health practices. It can be used for immediate detection of epidemics or long-term monitoring of disease trends. Active surveillance employs staff to directly collect data while passive surveillance relies on voluntary reporting from healthcare providers. Syndromic surveillance monitors clinical symptoms before confirmation of diagnoses. Integrated disease surveillance at national and global levels aims to strengthen communicable disease monitoring through standardized guidelines and collaboration across networks.
Fast-track the end of AIDS in the EU - practical evidence-based interventions.
Presentation by: Sophocles Chanos
In a two-day meeting under the auspices of the Maltese Presidency of the Council of the European Union (30-31 January 2017), HIV experts from across the European Union discussed how to reverse this trend and how to prepare Europe to achieve the set target of ending AIDS by 2030.
The latest recommendations by WHO on HIV treatment--New GuidelinesSyriacus Buguzi
This document provides consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. It includes recommendations for a public health approach across the continuum of HIV care, from diagnosis to treatment to monitoring. The guidelines were developed by the World Health Organization and draw on the most recent evidence from multiple sources. They are intended to guide national HIV programs in providing optimal HIV treatment, care, and prevention.
This presentation on research about HIV self-testing in Australia was given by A/Prof Rebecca Guy, The Kirby Institute, at the AFAO Members Forum - May 2015.
Fast-track the end of AIDS in the EU - practical evidence-based interventions.
Presentation by: Mika Salminen, European HA-REACT project
In a two-day meeting under the auspices of the Maltese Presidency of the Council of the European Union (30-31 January 2017), HIV experts from across the European Union discussed how to reverse this trend and how to prepare Europe to achieve the set target of ending AIDS by 2030.
This document proposes a clinical trial to evaluate the accuracy of the QikTech One-Step HIV I/II/O Saliva Test compared to a conventional blood test. The trial would enroll 250+ individuals across medical centers in Tijuana, Mexico. Participants would receive both tests, and positive results would undergo further confirmatory testing. If found to be accurate, the saliva test could provide a simpler alternative for HIV screening in Mexico and be commercialized in the country. The proposed trial outlines inclusion criteria, sample collection processes, testing procedures, statistical analysis plans, and anticipated outcomes of increased access to rapid and flexible HIV detection tools.
Presentation by Teymur Noori, ECDC, at AIDS 2018 conference during teh joint ECDC and EACS satellite "Getting to 90: Addressing inequalities in the HIV continuum of care in Europe and Central Asia"
This document reviews barriers towards achieving immunization coverage targets in Afghanistan. It identifies several barriers at the community, health facility, and health system levels that contribute to immunization rates remaining below targets. These include low socioeconomic status, lack of awareness, ineffective service delivery strategies, shortage of human and financial resources, weak coordination, and lack of accountability. The document proposes strategies to improve coverage across six areas: service delivery, demand generation, disease control, surveillance, introduction of new vaccines, and use of new technologies. Addressing barriers at all levels of the health system through better planning, monitoring, resources, and accountability is needed to increase immunization rates in Afghanistan.
This document summarizes the development of a screening algorithm for sexually transmitted infections. Key points:
- The algorithm is risk-based to guide healthcare providers on STI screening based on a client's risk factors.
- It was created by reviewing six STI guidelines and incorporates routine screening recommendations as well as risk-based screening.
- The algorithm provides guidance on screening for specific populations like pregnant individuals, MSM, and those with higher risk behaviors.
- Supplementary tools were also developed to aid implementation of the algorithm, and an accompanying survey found providers found the tools generally useful though some found the algorithm cluttered.
HIV self-testing and linkage in Africa. The document summarizes a presentation on HIV self-testing research in Africa. It discusses (1) the need for HIV self-testing in Africa due to low testing rates and knowledge of HIV status, (2) completed and ongoing studies of HIV self-testing in various African countries, and (3) priorities for future research including improving accuracy, evaluating new models for linkage to care, and assessing implementation in different populations and settings.
World Hepatitis Day is observed annually on July 28th to raise global awareness of viral hepatitis. The objectives are to involve people in focusing on hepatitis, raise awareness of the types and transmission, educate about prevention, diagnosis and control, and increase access to vaccines, treatment and skilled healthcare workers. Viral hepatitis B and C affect 325 million people globally and are among the leading causes of liver cancer and death. Standard precautions and employee health programs are key infection control strategies in healthcare facilities to prevent the transmission of hepatitis viruses.
Provides information on management of gonorrhea and chlamydia in patients with HIV, including clinical recommendations and key points regarding transmission, prevention, screening, presentation, diagnosis, treatment, follow-up and management of treatment failure, and partner exposure.
Find more information at https://www.hivguidelines.org/sti-care/gonococcal-and-chlamydial-infections/
Sponsored by the New York State Department of Health (NYSDOH) AIDS Institute (AI) and the HIV Clinical Guidelines Program
current hiv situation in india and national aids control programme an overviewikramdr01
The document provides information about an orientation programme for doctors on the National AIDS Control Programme (NACO) in India. It will take place on December 26-27, 2013 at the Government Thiruvarur Medical College and Hospital in Thiruvarur, India. The programme will provide an overview of the current HIV situation in India, NACO's objectives and approaches, national guidelines for detecting HIV, and NACO's comprehensive HIV care and antiretroviral therapy (ART) services.
Fast-track the end of AIDS in the EU - practical evidence-based interventions.
Presentation by: Valerie Delpech, Public Health Engand
In a two-day meeting under the auspices of the Maltese Presidency of the Council of the European Union (30-31 January 2017), HIV experts from across the European Union discussed how to reverse this trend and how to prepare Europe to achieve the set target of ending AIDS by 2030.
The document provides guidelines for healthcare providers in New York State on pre-exposure prophylaxis (PrEP) for HIV prevention. It recommends that PrEP with tenofovir/emtricitabine should be offered to individuals at high risk of acquiring HIV. PrEP has been shown to be over 90% effective in reducing HIV risk when taken daily as prescribed, but requires adherence to daily dosing and regular medical monitoring including HIV and STI testing every 3 months. The guidelines provide recommendations on candidate selection, counseling, prescribing and follow up care for individuals on PrEP.
The document discusses metrics for monitoring the cascade of HIV services across the continuum of care. It presents a conceptual framework showing the cascade from diagnosis to viral suppression. Key metrics are identified to measure progress at each stage, including the percentage of people living with HIV who know their status, are linked to care, initiated on antiretroviral therapy, and have achieved viral suppression. The metrics were field tested in two countries and found useful for program assessment. Challenges include data quality and capacity at the local level. Guidelines will be published in early 2014 to help countries use these metrics to identify gaps and improve program performance.
The document discusses training nurses to care for patients during epidemics and pandemics. It emphasizes the importance of infection control practices like universal precautions, proper sanitation, and use of personal protective equipment. Hospitals need emergency response plans that include staff education, isolation protocols, environmental cleaning, and collaborating with public health authorities during infectious disease outbreaks. Primary healthcare is a priority that needs to be strengthened to improve preparedness and response to future health crises.
This document provides an overview of infection control in healthcare settings. It defines healthcare-associated infections and outlines some of the major reasons they are rising in hospitals, such as advancing patient age and increased antibiotic resistance. Consequences of healthcare-associated infections include increased morbidity, prolonged hospitalization, increased costs, and death. Effective infection control requires surveillance, monitoring, investigation of potential outbreaks, management to interrupt outbreaks, and staff training. New technologies like antimicrobial surfaces and UV light are showing promise in reducing healthcare-associated infections. Ongoing challenges include decreasing funds, increasing drug resistance, and ensuring adequate physician leadership and engagement in quality improvement efforts.
Optimal HIV testing strategies to achieve high levels of HIV diagnosis in Sou...Carmen Figueroa
This document discusses optimal HIV testing strategies to achieve high levels of HIV diagnosis in South Africa. It summarizes that while South Africa has made progress towards diagnosing 90% of HIV cases by 2020, testing gaps remain, particularly for men, youth, and key populations. The document outlines using an agent-based model to assess the efficiency and cost-effectiveness of various testing strategies, such as home-based testing, mobile testing, and targeted testing of sex workers and partners of diagnosed individuals. Preliminary findings suggest strategies like assisted partner notification and testing sex workers and men who have sex with men could be highly cost-effective in increasing diagnoses and reducing undiagnosed cases.
Cost of testing per new HIV diagnosis as a metric for monitoring cost-effecti...Carmen Figueroa
This document analyzes the cost-effectiveness of additional HIV testing programs in southern Africa beyond core testing through mathematical modeling. It finds that using the cost-per-new-HIV-diagnosis as a metric, additional testing programs for men are likely cost-effective if the cost is below $585 per diagnosis. However, additional testing programs for women are unlikely to be cost-effective. The analysis is based on simulating 1000 scenarios of HIV epidemics and testing programs in southern Africa to examine outcomes and costs over 50 years.
Public health surveillance involves the continuous collection and analysis of health data to support public health practices. It can be used for immediate detection of epidemics or long-term monitoring of disease trends. Active surveillance employs staff to directly collect data while passive surveillance relies on voluntary reporting from healthcare providers. Syndromic surveillance monitors clinical symptoms before confirmation of diagnoses. Integrated disease surveillance at national and global levels aims to strengthen communicable disease monitoring through standardized guidelines and collaboration across networks.
Fast-track the end of AIDS in the EU - practical evidence-based interventions.
Presentation by: Sophocles Chanos
In a two-day meeting under the auspices of the Maltese Presidency of the Council of the European Union (30-31 January 2017), HIV experts from across the European Union discussed how to reverse this trend and how to prepare Europe to achieve the set target of ending AIDS by 2030.
The latest recommendations by WHO on HIV treatment--New GuidelinesSyriacus Buguzi
This document provides consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. It includes recommendations for a public health approach across the continuum of HIV care, from diagnosis to treatment to monitoring. The guidelines were developed by the World Health Organization and draw on the most recent evidence from multiple sources. They are intended to guide national HIV programs in providing optimal HIV treatment, care, and prevention.
This presentation on research about HIV self-testing in Australia was given by A/Prof Rebecca Guy, The Kirby Institute, at the AFAO Members Forum - May 2015.
Fast-track the end of AIDS in the EU - practical evidence-based interventions.
Presentation by: Mika Salminen, European HA-REACT project
In a two-day meeting under the auspices of the Maltese Presidency of the Council of the European Union (30-31 January 2017), HIV experts from across the European Union discussed how to reverse this trend and how to prepare Europe to achieve the set target of ending AIDS by 2030.
This document proposes a clinical trial to evaluate the accuracy of the QikTech One-Step HIV I/II/O Saliva Test compared to a conventional blood test. The trial would enroll 250+ individuals across medical centers in Tijuana, Mexico. Participants would receive both tests, and positive results would undergo further confirmatory testing. If found to be accurate, the saliva test could provide a simpler alternative for HIV screening in Mexico and be commercialized in the country. The proposed trial outlines inclusion criteria, sample collection processes, testing procedures, statistical analysis plans, and anticipated outcomes of increased access to rapid and flexible HIV detection tools.
Presentation by Teymur Noori, ECDC, at AIDS 2018 conference during teh joint ECDC and EACS satellite "Getting to 90: Addressing inequalities in the HIV continuum of care in Europe and Central Asia"
This document reviews barriers towards achieving immunization coverage targets in Afghanistan. It identifies several barriers at the community, health facility, and health system levels that contribute to immunization rates remaining below targets. These include low socioeconomic status, lack of awareness, ineffective service delivery strategies, shortage of human and financial resources, weak coordination, and lack of accountability. The document proposes strategies to improve coverage across six areas: service delivery, demand generation, disease control, surveillance, introduction of new vaccines, and use of new technologies. Addressing barriers at all levels of the health system through better planning, monitoring, resources, and accountability is needed to increase immunization rates in Afghanistan.
This document summarizes the development of a screening algorithm for sexually transmitted infections. Key points:
- The algorithm is risk-based to guide healthcare providers on STI screening based on a client's risk factors.
- It was created by reviewing six STI guidelines and incorporates routine screening recommendations as well as risk-based screening.
- The algorithm provides guidance on screening for specific populations like pregnant individuals, MSM, and those with higher risk behaviors.
- Supplementary tools were also developed to aid implementation of the algorithm, and an accompanying survey found providers found the tools generally useful though some found the algorithm cluttered.
HIV self-testing and linkage in Africa. The document summarizes a presentation on HIV self-testing research in Africa. It discusses (1) the need for HIV self-testing in Africa due to low testing rates and knowledge of HIV status, (2) completed and ongoing studies of HIV self-testing in various African countries, and (3) priorities for future research including improving accuracy, evaluating new models for linkage to care, and assessing implementation in different populations and settings.
World Hepatitis Day is observed annually on July 28th to raise global awareness of viral hepatitis. The objectives are to involve people in focusing on hepatitis, raise awareness of the types and transmission, educate about prevention, diagnosis and control, and increase access to vaccines, treatment and skilled healthcare workers. Viral hepatitis B and C affect 325 million people globally and are among the leading causes of liver cancer and death. Standard precautions and employee health programs are key infection control strategies in healthcare facilities to prevent the transmission of hepatitis viruses.
Provides information on management of gonorrhea and chlamydia in patients with HIV, including clinical recommendations and key points regarding transmission, prevention, screening, presentation, diagnosis, treatment, follow-up and management of treatment failure, and partner exposure.
Find more information at https://www.hivguidelines.org/sti-care/gonococcal-and-chlamydial-infections/
Sponsored by the New York State Department of Health (NYSDOH) AIDS Institute (AI) and the HIV Clinical Guidelines Program
current hiv situation in india and national aids control programme an overviewikramdr01
The document provides information about an orientation programme for doctors on the National AIDS Control Programme (NACO) in India. It will take place on December 26-27, 2013 at the Government Thiruvarur Medical College and Hospital in Thiruvarur, India. The programme will provide an overview of the current HIV situation in India, NACO's objectives and approaches, national guidelines for detecting HIV, and NACO's comprehensive HIV care and antiretroviral therapy (ART) services.
This document provides guidelines for managing Immune Reconstitution Inflammatory Syndrome (IRIS) in HIV patients. It defines IRIS and discusses its clinical presentations. It recommends starting antiretroviral therapy (ART) within 2 weeks of treating opportunistic infections to prevent IRIS and monitoring patients closely after starting ART. For severe IRIS, it recommends consulting an HIV expert and treating with corticosteroids in most cases, excluding cryptococcal meningitis or Kaposi's sarcoma. ART should not be interrupted for IRIS except in life-threatening situations.
This document discusses HIV/AIDS treatment using different medicinal systems. It begins by defining HIV/AIDS and describing how it is transmitted. It then discusses testing options for HIV and the various symptoms of HIV/AIDS. The document outlines the classification and examples of different antiretroviral medicines used to treat HIV/AIDS. It also discusses the possible role of herbal drugs from Ayurveda and Siddha in HIV treatment. Methods of prevention and control of HIV/AIDS are presented, including immunization recommendations. The conclusion emphasizes the importance of collaboration between allopathic and traditional medicine sectors in comprehensive HIV/AIDS treatment strategies.
Egypt has the largest hepatitis C virus (HCV) epidemic in the world, with around 12% of the population infected. Unsafe injection practices from medical procedures are a major source of HCV transmission in Egypt. A suggested national HCV prevention strategy includes: 1) primary prevention through safe injection practices and infection control; 2) secondary prevention by identifying infected individuals and reducing transmission risk; 3) educating healthcare workers and the public; and 4) conducting surveillance and evaluating prevention activities. The strategy aims to prevent new HCV infections and reduce the risk of chronic liver disease in infected individuals through medical management and lifestyle changes.
This document provides an update on the Infectious Diseases in Pregnancy Screening (IDPS) Programme in the UK. It discusses the aims of the programme, which include enabling early detection and treatment of infections in pregnancy to reduce mother-to-child transmission. It summarizes screening activity data which shows high uptake rates of over 99% for HIV, hepatitis B, and syphilis screening. It also discusses efforts to improve laboratory quality, establish screening standards and outcomes data, and provide education resources to professionals and the public. Specific updates are provided on actions relating to HIV, syphilis, hepatitis B, and developing seamless maternal and neonatal pathways between screening and immunization programs.
Hiv &ictc seminar by Dr. Mousumi Sarkarmrikara185
India's national adult HIV prevalence is estimated at 0.26%. The total number of people living with HIV in India is estimated to be 21.17 lakhs. India has one of the world's largest HIV surveillance systems which helps monitor trends, levels, and burden of HIV among different populations. This system includes sentinel surveillance at antenatal clinics, Integrated Biological and Behavioural Surveillance among high-risk groups, sexually transmitted infection surveillance, AIDS case reporting, and death registration. The surveillance data is used to estimate disease distribution, identify groups for intervention, evaluate program effectiveness, and guide prevention efforts.
This document summarizes information about hepatitis C in Ireland, including epidemiology, natural history, burden, treatment programs, and guidelines. Some key points:
- An estimated 20,000-30,000 people in Ireland have chronic hepatitis C infection, though about 60% are undiagnosed.
- Most infections are in people who inject drugs, though cases in men who have sex with men are increasing.
- A national hepatitis C treatment program was established in 2015 to treat all infected individuals over several phases, with a goal of eliminating hepatitis C in Ireland by 2026.
- National hepatitis C screening guidelines were developed using an evidence-based process and are due to be launched in July 2017 to facilitate increased
Dr. Anna Garner presented on updates in HIV and STIs. Key points included:
1) Late HIV diagnosis remains an issue in the UK, with many patients presenting only after developing AIDS-related illnesses. Missed opportunities for earlier testing contribute to late diagnoses.
2) STIs such as LGV have seen resurgences in certain populations. Ocular syphilis can also present an atypical symptom of syphilis infection.
3) Increased HIV and STI testing is needed in high prevalence areas. All healthcare providers should consider HIV in their differential and offer testing when appropriate to diagnose more patients earlier.
This document provides an overview of the 2019 novel coronavirus (2019-nCoV) outbreak that began in Wuhan, China in December 2019. It describes the clinical presentation and management of 2019-nCoV, compares it to other coronaviruses like SARS and MERS, and outlines current WHO guidance on case definitions, investigations and infection control.
Dr. Ian McGowan, Chief Medical Officer at Orion Biotechnology, presented at the ASCO 2019 conference in Chicago. His presentation was in the Gastrointestinal (Colorectal) cancer track and focused on the surveillance and management of anal intraepithelial neoplasia in HIV and non-HIV infected patients.
This document provides an overview of paediatric HIV/AIDS and challenges of management in Nigeria. It discusses the epidemiology of HIV globally and in Nigeria, where the disease burden is highest. It covers pathogenesis, transmission, clinical manifestations, diagnosis, treatment including antiretroviral therapy, and challenges in management. In Nigeria, paediatric HIV care began in 2004 and the strategic plan aims to scale up access to care, treatment and support for infected and exposed children. Management of paediatric HIV presents many challenges.
The document provides information about COVID-19 and the NSW Health response. It defines SARS-CoV-2, the virus that causes COVID-19, and details the timeline of the outbreak worldwide and in Australia. It describes NSW Health's response, which includes establishing clinical councils, providing advice to healthcare workers, developing diagnostic tests, managing cases through infection control and public health measures, and regular public updates. It provides guidance on case definitions, testing criteria, and infection prevention and control strategies to prevent transmission, including the use of personal protective equipment and isolation for suspected or confirmed cases.
This document discusses Zika virus and provides information for clinicians. It describes the epidemiology of Zika virus, including transmission and outbreaks in the Americas. It outlines the clinical presentation of Zika virus disease and discusses diagnostic testing. It also addresses maternal-fetal transmission of Zika virus and the relationship between Zika virus infection during pregnancy and microcephaly in infants.
The Revised National Tuberculosis Control Programme (RNTCP) in India has the following key objectives:
1) To achieve and maintain at least 85% cure rate amongst new smear positive tuberculosis cases and 70% case detection rate.
2) To provide universal access to tuberculosis treatment through the DOTS (Directly Observed Treatment, Short-course) strategy where a treatment observer watches patients take their medication.
3) To introduce programmatic management of drug resistant tuberculosis through standardized regimens using second-line drugs under the DOTS strategy.
Epidemiology of HIV & AIDS.pptx presentation 2024Motahar Alam
Epidemiology of HIV/AIDS encompasses the study of the distribution and determinants of HIV infection and AIDS-related illnesses within populations. HIV (Human Immunodeficiency Virus) is the virus that causes AIDS (Acquired Immunodeficiency Syndrome), a condition characterized by a weakened immune system, making individuals susceptible to various infections and illnesses.
Key aspects of the epidemiology of HIV/AIDS include:
Prevalence and Incidence: Prevalence refers to the total number of people living with HIV/AIDS within a population at a specific time, while incidence refers to the rate of new infections occurring within a given period. These measures help understand the burden of the disease and its spread over time.
Demographic Patterns: HIV/AIDS affects different demographic groups differently. Factors such as age, gender, race/ethnicity, socioeconomic status, and geographical location can influence susceptibility, access to healthcare, and outcomes. For example, in many regions, young adults and certain minority populations may have higher rates of infection.
Transmission Routes: Understanding how HIV is transmitted is crucial for prevention efforts. HIV primarily spreads through unprotected sexual intercourse, sharing contaminated needles or syringes, and from mother to child during childbirth or breastfeeding. Other modes of transmission include blood transfusions (though rare in regions with screening protocols) and occupational exposure.
Risk Factors: Certain behaviors and circumstances increase the risk of HIV transmission. These include having multiple sexual partners, engaging in unprotected sex, using intravenous drugs, lack of access to healthcare, poverty, stigma, and discrimination. Additionally, structural factors such as laws and policies can influence risk behaviors and access to prevention and treatment services.
Global Distribution: HIV/AIDS is a global pandemic, but its prevalence varies widely between countries and regions. Sub-Saharan Africa remains the most affected, with the highest burden of HIV infections worldwide. However, significant progress has been made in some regions, while new challenges emerge in others, such as Eastern Europe and Central Asia.
Progress in Prevention and Treatment: Efforts to combat HIV/AIDS include prevention strategies such as promoting condom use, harm reduction programs for injecting drug users, pre-exposure prophylaxis (PrEP), and comprehensive sexual education. Antiretroviral therapy (ART) has transformed HIV/AIDS into a manageable chronic condition for many, reducing mortality and transmission rates.
Challenges and Future Directions: Despite significant progress, challenges remain in the global response to HIV/AIDS. These include disparities in access to healthcare, stigma and discrimination, funding gaps, emergence of drug-resistant strains, and persistent barriers to prevention and treatment in certain populations.
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2. Purpose of the Guideline
• Increase the numbers of NYS residents with HIV and syphilis coinfection who are
identified and treated with effective interventions.
• Support the NYSDOH Prevention Agenda 2013-2018 to reduce the case rate of
primary and secondary syphilis by 10% to no more than 10.1 cases per 100,000
men and 0.4 cases per 100,000 women and reduce disparities for specific
populations that are disproportionately affected by syphilis infection.
• Reduce growing burden of morbidity and mortality associated with syphilis
infection.
• Integrate current evidence-based clinical recommendations into the healthcare-
related implementation strategies of the Ending the Epidemic initiative, which seeks
to end the AIDS epidemic in New York State by the end of 2020.
Syphilis 2/28/19 NYSDOH AIDS Institute Clinical Guidelines Program www.hivguidelines.org
3. Recommendations:
Transmission and Prevention
Clinicians should:
Inform patients with HIV infection about the risk of acquiring syphilis and other STIs from close physical
contact with all sites of possible exposure, including the anus, cervix, vagina, urethra, tongue, oropharynx,
or any other location where a syphilitic chancre is present. (A3)
When patients with HIV infection are diagnosed with early syphilis (primary, secondary, or early latent
stage), clinicians should educate patients about the following: risk-reduction strategies, including the value
of condom use (A2); the potential for oral transmission of syphilis (A3); the benefits of identifying infection
early (A3); and the need for prompt evaluation and therapy for sex partners (A3).
Perform gonorrhea and chlamydia testing for any patient with HIV infection who receives a new diagnosis
of syphilis infection. (A2)
Ask all patients about sexual behaviors and new sex partners at each routine monitoring visit to assess for
risk behaviors that require repeat or ongoing screening. (A3)
Syphilis 2/28/19 NYSDOH AIDS Institute Clinical Guidelines Program www.hivguidelines.org
4. Who to Screen?
• All patients with HIV infection should be serologically screened for syphilis
at least once per year.
• MSM who engage, or whose partners may engage, in continued high-risk
behavior should be serologically screened for syphilis at least every 3
months.
• The diagnosis of another bacterial STI in a patient with HIV infection or
a patient’s sex partner should prompt a clinician to perform a syphilis
screening test and to consider more frequent screening for syphilis.
• Pregnant patients with HIV infection should be serologically screened
for syphilis at the first prenatal visit.
Syphilis 2/28/19 NYSDOH AIDS Institute Clinical Guidelines Program www.hivguidelines.org
5. Recommendations: Screening Frequency
Clinicians should obtain serologic screening for syphilis at least annually for all patients with HIV infection. (A2)
In response to the current epidemiology in NYS, clinicians should perform syphilis screening every 3 months
(A3) for HIV-infected MSM at highest risk of syphilis infection, including those who:
• Report, or whose partners report, multiple or
anonymous sex partners. (A3)
• Have been, or whose sex partners have been,
diagnosed with or treated for a bacterial STI
since the last evaluation. (A3)
• Engage, or whose sex partners may engage,
in sexual activity at sex partiers or other high-
risk venues. (A3)
• Are involved, or whose sex partners may be
involved, in transactional sex (e.g., sex workers
and their clients). (A3)
• Report recreational substance use during sexual
activity. (A3)
• Self-identify as at high risk of STIs. (A3)
Clinicians should obtain serologic screening for syphilis for pregnant patients with HIV infection at the first
prenatal visit. (A2)
Syphilis 2/28/19 NYSDOH AIDS Institute Clinical Guidelines Program www.hivguidelines.org
6. Key Points: Screening Frequency
Syphilis 2/28/19 NYSDOH AIDS Institute Clinical Guidelines Program www.hivguidelines.org
STI screening should be performed every 3 months for persons at high
risk regardless of the frequency of their HIV monitoring visits.
Regular assessment of ongoing risk behavior enables clinicians to
determine the appropriate frequency of screening. Clinicians can seek
training to enhance their comfort with sexual history-taking and to
develop nonjudgmental approaches to educating patients about the
importance of STI screening.
The NYSDOH Clinical Education Initiative (CEI) provides HIV, HCV, and STI-
related training and educational resources for clinical care providers.
www.ceitraining.org
7. Recommendations:
Presentation, Diagnosis, and Reporting
As part of the initial and then annual comprehensive physical
examination for patients with HIV infection, clinicians should examine
all skin and mucosal surfaces for lesions, especially less-visible areas,
such as the anus, cervix, vagina, vulva, urethra, oropharynx, and under
the foreskin in uncircumcised males. (A3)
Clinicians should perform a neurologic review of systems, including
ophthalmologic and otic, for all patients with HIV infection who are
diagnosed with syphilis and follow up with further neurologic
evaluation. (A2)
Syphilis 2/28/19 NYSDOH AIDS Institute Clinical Guidelines Program www.hivguidelines.org
8. Recommendations: Presentation,
Diagnosis, and Reporting, continued
Because the chancres of primary syphilis are usually painless and may go unnoticed by the
patient, it is important that the clinician examine all skin and mucosal surfaces of patients with
HIV infection during the annual comprehensive physical examination.
Syphilis should be included as part of the differential diagnosis for patients presenting with oral,
genital, cervical, or anal lesions; rash; eye disease or vision complaints; aortitis; or neurological
disease.
Definitive diagnosis of syphilis is made either serologically or, if available, by identification of the
causative organism.
Clinicians should ensure that two-stage syphilis testing is performed by the laboratory if the
initial screen is reactive. (A1)
Clinicians should perform a nontreponemal test, such as the RPR or VDRL test, for repeat
screening in patients who have a history of syphilis infection. (A1)
Syphilis 2/28/19 NYSDOH AIDS Institute Clinical Guidelines Program www.hivguidelines.org
9. Syphilis 2/28/19 NYSDOH AIDS Institute Clinical Guidelines Program www.hivguidelines.org
Standard Protocol
for Syphilis
Screening and
Diagnosis
[AIDSinfo 2017]
10. Syphilis 2/28/19 NYSDOH AIDS Institute Clinical Guidelines Program www.hivguidelines.org
Alternative,
Reverse Algorithm
for Syphilis
Screening and
Diagnosis
[CDC 2011; AIDSinfo 2017]
11. Key Points:
Difficulties with Interpreting Syphilis Serologies
Syphilis 2/28/19 NYSDOH AIDS Institute Clinical Guidelines Program www.hivguidelines.org
All syphilis serologic tests may be falsely negative early in infection,
including at the initial appearance of the syphilitic chancre.
Serum samples containing large amounts of nontreponemal reagin rarely,
but occasionally, demonstrate a false-negative reaction, known as a
prozone reaction.
• When there is clinical suspicion of syphilis but the nontreponemal test
result is negative, clinicians should order laboratory dilution and
retesting of the sample.
Treponemal tests rarely produce false-negative results; however, if
clinical suspicion is high, an alternative treponemal test should be
considered.
12. Key Point: Diagnosis
Syphilis 2/28/19 NYSDOH AIDS Institute Clinical Guidelines Program www.hivguidelines.org
Serologic test results are negative in patients with incubating
syphilis, and the sensitivity of serologic tests is approximately
80% during the early primary stage 3 of syphilis (i.e., within the
first 10 days after the lesion appears).
13. Recommendations:
Diagnosis of Neurosyphilis
Clinicians should include neurosyphilis in the differential diagnosis of all
patients with HIV infection who present with neurologic, ophthalmologic,
otic, or neuropsychiatric signs or symptoms. (A2)
Clinicians should perform a lumbar puncture in patients with HIV
infection who have syphilis or a history of syphilis when patients present
with the following:
• Neurologic, ophthalmologic, otic, or neuropsychiatric signs or
symptoms that are not explained by another etiology. (A2)
• Evidence of treatment failure. (A2)
• Evidence to active tertiary syphilis (aortitis, gummas). (A3)
Syphilis 2/28/19 NYSDOH AIDS Institute Clinical Guidelines Program www.hivguidelines.org
14. Reporting
Syphilis 2/28/19 NYSDOH AIDS Institute Clinical Guidelines Program www.hivguidelines.org
Clinicians must report all suspected or confirmed syphilis
diagnoses to the local health department of the area where
the patient resides according to NYS requirements.
15. Recommendations: Treatment
Because of the possibility of false-negative test results in primary syphilis,
clinicians should presumptively treat patients at risk of syphilis who present with
a lesion typical of a syphilitic chancre. (A3)
Clinicians should use long-acting benzathine penicillin G as the recommended
treatment for syphilis in patients with HIV. (A2)
Clinicians should use only penicillin to treat all stages of syphilis in pregnant
patients. (A2)
Clinicians should obtain baseline and monthly assessment of serum
nontreponemal reagin levels when treating syphilis in pregnant patients with
HIV if the risk of syphilis reinfection is high. (A3)
7/23/2019 NYSDOH AIDS Institute Clinical Guidelines Program
16. Key Points: Treatment and Follow-Up
To avoid use of the incorrect pharmaceutical preparation of
penicillin, clinicians should ensure that long-acting benzathine
penicillin G (i.e., Bicillin LA and not Bicillin CR) is ordered.
Treatment failure in a person with HIV infection warrants
cerebrospinal fluid examination and treatment based on test
results.
Syphilis 2/28/19 NYSDOH AIDS Institute Clinical Guidelines Program www.hivguidelines.org
17. Recommendations:
Treatment in Penicillin-Allergic Patients
Clinicians should administer desensitization therapy followed by penicillin
therapy to treat penicillin-allergic patients who have neurosyphilis, other
forms of tertiary syphilis, syphilis in pregnancy, or syphilis that cannot be
treated by an alternative regimen. (A2)
Clinicians should administer desensitization therapy for patients with HIV
infection, followed by penicillin therapy, rather than attempt alternative
therapies if adherence to therapy or close follow-up cannot be ensured. (A3)
Clinicians should not prescribe azithromycin to treat syphilis in patients with
HIV infection. (A2)
Syphilis 2/28/19 NYSDOH AIDS Institute Clinical Guidelines Program www.hivguidelines.org
18. Recommendation:
Jarisch-Herxheimer Reaction
In women treated for syphilis infection during the second half of their
pregnancy, clinicians should:
• Obtain a fetal sonogram to evaluate for congenital syphilis. (A2)
• Advise women who experience fever, contractions, or a decrease in fetal
moments to seek immediate obstetric care. (A2)
Key Point: Early labor and fetal distress are associated with the Jarisch-
Herxheimer reaction. Prompt medical care should be sought by women
receiving syphilis treatment during their second half of pregnancy if they
experience fever, contractions, or a decrease in fetal movements.
Syphilis 2/28/19 NYSDOH AIDS Institute Clinical Guidelines Program www.hivguidelines.org
19. Recommendation: Treatment Failure
Clinicians should perform CSF
examination for patients who
experience treatment failure, and:
• Initiate parenteral therapy using a
recommended penicillin regimen
for neurosyphilis if CSF test results
are negative (A2);
• Treat using a recommended
penicillin regimen for late latent
syphilis if CSF test results are
positive. (A2)
Syphilis 2/28/19 NYSDOH AIDS Institute Clinical Guidelines Program www.hivguidelines.org
Definition of treatment failure: In the absence
of potential exposure for reinfection, treatment
failure is defined by any of the following:
• Persistence or development of new clinical
signs or symptoms potentially related
to syphilis, such as rashes, ulcers,
neurologic/ophthalmic signs or symptoms,
or gummas.
• Four-fold increase in nontreponemal serology
(e.g., RPR 1:4 increases to 1:16).
• Failure of the nontreponemal serology
to decrease 4-fold within 12 to 24 months
of treatment.
20. New York State Requirements:
Sex Partner Exposure to Syphilis and HIV
• NYS Public Health Law requires that clinicians report all
suspected or confirmed syphilis and HIV diagnoses to the local
health department in the area where the patient resides.
• NYS Public Health Law requires that medical providers talk
with HIV-infected individuals about their options for informing
their sex and need-sharing partners that they may have been
exposed to HIV and syphilis, including the free confidential
partner notification assistance offered by NYSDOH and NYC
DOHMH.
Syphilis 2/28/19 NYSDOH AIDS Institute Clinical Guidelines Program www.hivguidelines.org
21. Recommendations:
Sex Partner Exposure to Syphilis and HIV
Clinicians should test and treat patients who report exposure to
syphilis according to the recommendations in the guideline. (A2)
When a patient with HIV infection is diagnosed with syphilis,
clinicians should advise the patient to encourage sex partners
and needle-sharing partners to seek medical care for possible
exposure to both HIV and syphilis. (A3)
Syphilis 2/28/19 NYSDOH AIDS Institute Clinical Guidelines Program www.hivguidelines.org
22. Key Points:
Sex Partner Exposure to Syphilis and HIV
When a patient with HIV infection is diagnosed with syphilis, the clinician should
inform the patient about the implications of the diagnosis for his/her sex partner(s):
• A new STI diagnosis signals that the patient was engaging in sexual behaviors
that place sex partners at increased risk of acquiring HIV infection.
• A sex partner may also have been exposed to syphilis and should be tested and
evaluated for treatment.
• The local health department may contact a sex partner confidentially about the
potential exposure and treatment options.
Clinicians should provide patients with information and counseling about notifying
partners, risk reduction, and safer sex practices
Syphilis 2/28/19 NYSDOH AIDS Institute Clinical Guidelines Program www.hivguidelines.org
24. Access the Guideline
www.hivguidelines.org > STI Care > Management of
Syphilis in Patients with HIV
Also available: Printable pocket guide; printable PDF
Syphilis 2/28/19 NYSDOH AIDS Institute Clinical Guidelines Program www.hivguidelines.org