Università degli studi di Modena e Reggio Emilia

Ageing and quality of life of patients affected by HIV: Modena experience at the European Parliament

Improving long-term health and wellness of people living with HIV: learning from the experiences of the single Countries.  This is the title of the meeting held in the past days at the headquarters of the European Parliament in Brussels, which saw the attendance of Professor Giovanni Guaraldi, who teaches metabolic clinics at UNIMORE and is an expert in infectious diseases at the University Hospital of Modena. The meeting was part of the initiatives of HIV Outcomes, an institution established in 2016 with the purpose of creating a joint working table in the Union on topics relating to quality of life and social inclusion of people affected by HIV, in order to provide a global response to the disease. Together with Professor Mario Cascio, deputy chairman of the European AIDS treatment group, professor Guaraldi showed the reports on HIV governance in Italy, each of them pointing out the positive aspects and weaknesses, in accordance with their own point of view. They also identified some possible solutions aimed at improving the status quo and implement, at a national level, the European recommendations approved last year by HIV Outcomes. More specifically, professor Guaraldi brought in Europe the experience of the multi-specialist programme intended to diagnose and treat the comorbidities and frailties associated with the HIV infection.

Professor Giovanni Guaraldi pointed out that “Nowadays, the antiretroviral treatment provides people living with HIV with a life expectancy similar to that of normal people. There are special cases, such as the one studied by the team in Modena, of a patient in Lisbon who is now 100 years old. However, modern treatments make us think of an intersection of HIV medicine, and this success leads us to study a new welfare model for people with HIV who are getting old: this model is well represented by the programme for comorbidities and frailties of the Polyclinic. This is the evidence that we have presented in Brussels.”

The Modena structure is patient-centred and all services are coordinated to offer a multidisciplinary assessment with one single access. At present, the average age of the patients looked after in the metabolic path is 52 years, therefore far from the geriatric age. However, all patients undergo a “comprehensive Geriatric assessment (CGA)” useful to assess not only the disease caused by the HIV virus and its comorbidities, but also the issues related to age and frailty, as well as the state of vulnerability of individuals and the risk of developing disabilities. The CGA is possible thanks to a strong integration between assistance and research, and the presence of dedicated professional figures such as occupational therapists, neuropsychologists, dieticians, and an health coach, i.e. a nurse specialised in promoting lifestyles.

The programme deals not only with the disease, but mainly with the help of people living with HIV, and measures the ageing paths by creating health indicators based on the World Health Organisation model. Professor Guaraldi ends by saying that “Our objective is to combine the implementation of clinic treatments with the education of people to develop correct lifestyles so that to ensure an healthy ageing also to people affected by HIV”.  The metabolic clinics is active since 2003. 5500 patients have been assessed. About 2500 patients are under treatment.

HIV Outcomes: what is it?

The HIV Outcomes initiative was created in 2016. At a time when people ageing and the sustainability of health care systems are big challenges for all European countries, the initiative is also aimed at providing the discussions with information on the economically effective strategies for preventing and managing comorbidity, at the same time ensuring the health care centred on the patient. Governments and healthcare systems are now facing a longer life of HIV patients, and have therefore to commit to ensure them a good ageing.

The HIV Outcomes initiative tries to integrate what is currently done in terms of prevention, diagnosis, treatment and care by developing sustainable approaches – such as better prevention, screening, and diagnosis of comorbidities – able to meet the specific long-term needs of people living with HIV.

Categorie: International - english