This Clinical Reference Group (CRG) covers human immunodeficiency virus (HIV) services. HIV is a virus that causes acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive. An estimated 104,000 people were living with HIV in the UK at the end of 2014, of whom almost 20% were unaware of their infection.
- Dr. David Asboe, Chair
- Heather Leake Date, Clinical Member
- Dr. Ashley Price, Clinical Member
- Dr. Iain Stephenson, Clinical Member
- Dr. Margaret Kingston, Clinical Member
- Rabia Gowa, Pharmacy Lead
- Angeline Walker, Public Health England
- Chris Buckley, Patient & Public Voice Representative
- Charles Kwaku-Odoi, Patient & Public Voice Representative
- Tristan Barber, Affiliate Member
- Joe Phillips, Affiliate Member
- Laura Waters, Affiliate Member
- Anna Kafkalias, Lead Commissioner
Spotlight on HIV
The treatment of HIV infection has been one of the most outstanding medical achievements over the last 25 years. The Spotlight on HIV highlights the of achievements and key milestones in HIV care in the NHS over the past 40 years.
A key part of the CRG’s work is the delivery of the ‘products’ of commissioning. These are the tools used by the 10 Hub Commissioning Teams to contract services on an annual basis.
Best Practice in HIV Prescribing and Multidisciplinary Teams
Best Practice in HIV Prescribing sets out the Clinical Reference Group’s principles for providing clinical advice to NHS England on HIV prescribing, including the role, composition and operation of multidisciplinary team (MDT) meetings.
Service specifications are important in clearly defining the standards of care expected from organisations funded by NHS England to provide specialised care. The specifications have been developed by specialised clinicians, commissioners, expert patients and public health representatives to describe both core and developmental service standards. Core standards are those that all funded providers should be able to demonstrate, with developmental standards being those which may require further changes in practice over time to provide excellence in the field.
The following service specifications fall within the scope of this CRG:
- Specialised Human Immunodeficiency Virus (HIV) Services (Adult)
- Specialised Human Immunodeficiency Virus Services (Children)
A commissioning policy is a document that defines access to a service for a particular group of patients. A NICE Technology Appraisal Guideline on the same topic will replace, or be incorporated into, a commissioning policy as appropriate. These are important documents that are developed to ensure consistency in access to treatments nationwide.
The following policies fall within the scope of this CRG:
- Reimbursement for the use of generic drugs for pre exposure prophylaxis (PrEP) for the prevention of HIV
- Dolutegravir / lamivudine for the treatment of Human Immunodeficiency Virus (HIV-1) infected adults and adolescents over 12 years of age
- Dolutegravir-rilpivirine for treating HIV-1 in adults
- Immediate antiretroviral therapy for treatment of HIV-1 in adults and adolescents
- Elvitegravir/cobicistat/emtricitabine/tenofovir for treatment of HIV in adults
- Use of cobicistat as a booster in treatment of HIV infection (all ages)
- Treatment as Prevention (TasP) in HIV infected adults
- Dolutegravir for treatment of HIV-1 infection (all ages) (updated January 2019)
- Doravirine for the treatment of HIV-1 in adults
- Tenofovir Alafenamide for treatment of HIV 1 in adults and adolescents
- Bictegravir-emtricitabine-tenofovir alafenamide for the treatment of HIV-1 in adults
PrEP trial updates
Between 2017 and 2020 NHS England and NHS Improvement funded a major extension to the national HIV prevention programme led by Public Health England with the aim of supporting those most at risk and reducing the incidence of HIV infection. The first phase of implementation was the launch of a large scale trial of anti-retroviral drugs for the prevention of HIV, known as pre-exposure prophylaxis (PrEP).
The PrEP Programme Oversight Board provided governance to make sure the PrEP trial was as good as it could be and that it progressed as planned. Updates from the Board meetings can be found here.
- PrEP trial update – February 2020
- PrEP trial update – October 2019
- PrEP trial update – April 2019
- PrEP trial update – January 2019
- PrEP trial update – June 2018
- PrEP trial update – March 2018
- PrEP trial update – January 2018
- PrEP trial update – November 2017
- PrEP trial update – September 2017
- PrEP trial update – June 2017
Please note that the recruitment to the trial has now ended and a routinely commissioned PrEP service is now being rolled out across England.