International HIV Experts Call for Focus on Quality of Life Beyond Viral Suppression
The Janssen Pharmaceutical Companies of Johnson & Johnson announces the first consensus white paper to be published by an esteemed group of experts who have come together to launch the “Moving Fourth” initiative. The initiative aims to tackle HIV-related health challenges faced by people living with HIV (PLWHIV), such as associated mental and physical co-morbidities, mental health issues, financial stresses and potential HIV-related stigma. The launch took place at the 17th European AIDS Conference in Basel, 6-9 November 2019.
Recommendations in the white paper, which have been summarised in AIDS Reviews , 1 focus on a new HIV care framework - Health Goals for Me. The recommendations were developed to support an holistic and individualised long-term treatment approach that goes beyond viral load and CD4 count, to assess health-related quality of life. Designed to empower healthcare professionals and PLWHIV to collaborate and mutually agree on objectives for care beyond viral suppression, the framework is comprised of a continuous cycle of ‘ask and measure’, ‘feedback and discussion’, and ‘intervention’.
“It is a pivotal moment in HIV,” said Dr Giovanni Guaraldi,* Chair of the Moving Fourth Expert Committee and Associate Professor of Infectious Disease and Head of the Modena HIV Metabolic Clinic (MHMC), Italy, in launching the group’s first paper. “Pioneering research means the disease is now viewed as a chronic condition. However, this brings new challenges relating to long-term health; as increasing numbers of people navigate their lives beyond viral suppression and look towards improved quality of life. Health Goals for Me should become an intrinsic part of HIV care in the future.”
This international, expert alignment represents a pathway to achieving the ‘fourth 90’, a goal that builds on the United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 treatment target.2 Through Health Goals for Me, the Moving Fourth Expert Committee aims to increase focus on taking an individualised long-term approach to patient care, which forms the basis of our continued work to develop practical tools which can help improve health-related quality of life for PLWHIV.
The UNAIDS proposed the ambitious 90-90-90 treatment plan in 2014 to end the AIDS epidemic: to diagnose 90% of all HIV-positive persons; provide antiretroviral therapy (ART) to 90% of those diagnosed; and to achieve viral suppression for 90% of those treated by 2020. These targets, however, do not cover other HIV-related health challenges faced by people living with HIV.
Mario Cascio,* Former-Chair of European AIDS Treatment Group (EATG), Italy, who lives with HIV and is a member of the expert committee said: “Treatment guidelines and policy for HIV are much the same as when it was a fatal disease. Despite HIV being considered a chronic condition, many people are suffering with the day-to-day impact of the disease, such as continued stigma, discrimination and health conditions experienced after many years of living with HIV. This international consensus represents an important first step to improve care beyond viral load and ultimately improve the lives of people living with HIV.”
“The Moving Fourth steering committee was convened to establish a way in which the ‘fourth 90’ can be achieved,” said Allitia diBernardo, Europe, Middle East and Africa Infectious Diseases and Vaccines Therapeutic Area Lead, Janssen-Cilag International NV. “The ultimate aim of this initiative is to provide clear, detailed guidelines and tools that support a holistic, individualised, long-term treatment approach for PLWHIV that goes beyond viral load and CD4 count. At Janssen we recognise that, despite progress made, HIV remains one of the greatest global health threats of our time. We won’t stop until we end HIV.”
The Moving Fourth steering committee members are:
- Dr Giovanni GUARALDI (Chair), Associate Professor of Infectious Disease and Head of the Modena HIV Metabolic Clinic (MHMC), Italy
- Dr Joop ARENDS, Internist, Associate Professor of Infectious Disease and Infectious Diseases Physician, Department of Internal Medicine and Infectious Diseases, University Medical Centre Utrecht, The Netherlands
- Dr Thomas BUHK, Internist, Infectiologist, Centers for Infectious Diseases in Hamburg (ICH-Hamburg), Germany
- Mario CASCIO Former-Chair, European AIDS Treatment Group (EATG), Italy
- Dr Adrian CURRAN, Internist, Infectious Disease Specialist, Department of Infectious Diseases, Vall d’Hebron University Hospital, Barcelona, Spain
- Dr Eugenio TEOFILO, Internist, Department of Internal Medicine at Hospital Dos Capuchos, Lisboa, Portugal
- Dr Guido VAN DEN BERK, Internist, Infectious Disease Specialist, Department of Internal Medicine, OLVG, City Hospital of Greater Amsterdam, The Netherlands
- Christian VERGER, Chair of the Grand Est region, Board member, AIDES-France, France
*Spokespeople involved have not been paid for media work. Dr. Giovanni Guaraldi reports personal fees from Janssen.
The White Paper was sponsored by Janssen-Cilag International NV one of the Pharmaceutical Companies of Johnson & Johnson. Each author received remuneration for the writing of the article and the fee for a medical writer was covered by Janssen. The views expressed are, however, the views of the authors and do not represent the views of Janssen.
About the Janssen Pharmaceutical Companies of Johnson & Johnson
At Janssen, we’re creating a future where disease is a thing of the past. We’re the Pharmaceutical Companies of Johnson & Johnson, working tirelessly to make that future a reality for patients everywhere by fighting sickness with science, improving access with ingenuity, and healing hopelessness with heart. We focus on areas of medicine where we can make the biggest difference: Cardiovascular & Metabolism, Immunology, Infectious Diseases & Vaccines, Neuroscience, Oncology, and Pulmonary Hypertension.
Cautions Concerning Forward-Looking Statements
This press release contains "forward-looking statements" as defined in the Private Securities Litigation Reform Act of 1995, regarding a new white paper which outlines an HIV management framework designed to help end the AIDS epidemic. The reader is cautioned not to rely on these forward-looking statements. These statements are based on current expectations of future events. If underlying assumptions prove inaccurate or known or unknown risks or uncertainties materialize, actual results could vary materially from the expectations and projections of Janssen-Cilag International NV, or any of the other Janssen Pharmaceutical Companies and/or Johnson & Johnson. Risks and uncertainties include, but are not limited to: challenges and uncertainties inherent in product research and development, including the uncertainty of clinical success and of obtaining regulatory approvals; uncertainty of commercial success; manufacturing difficulties and delays; competition, including technological advances, new products and patents attained by competitors; challenges to patents; product efficacy or safety concerns resulting in product recalls or regulatory action; changes in behavior and spending patterns of purchasers of health care products and services; changes to applicable laws and regulations, including global health care reforms; and trends toward health care cost containment. A further list and descriptions of these risks, uncertainties and other factors can be found in Johnson & Johnson's Annual Report on Form 10-K for the fiscal year ended December 30, 2018, including in the sections captioned “Cautionary Note Regarding Forward-Looking Statements” and “Item 1A. Risk Factors,” in the company’s most recently filed Quarterly Report on Form 10-Q and in the company’s subsequent filings with the Securities and Exchange Commission. Copies of these filings are available online at www.sec.gov, www.jnj.com or on request from Johnson & Johnson. Neither of the Janssen Pharmaceutical Companies nor Johnson & Johnson undertakes to update any forward-looking statement as a result of new information or future events or developments.
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1 Giovanni G, Joop A, Thomas B, et al. 'Moving fourth’: a Vision Towards Achieving Healthy Living with HIV Beyond Viral Suppression. AIDS Reviews. 2019; 21(3).
2 UNAIDS. 90-90-90. Published 2014. An ambitious treatment target to help end the AIDS epidemic. Available from: http://www.unaids.org/sites/default/files/media_asset/90-90-90_en_0.pdf. [Last accessed: November 2019].
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