PhD defence S. (Stephanie) Popping

With the firm recommendation of the WHO and UNAIDS to eliminate HCV and HIV as a public health treat by 2030 several topics need addressing. Both viral diseases have an enormous public health impact and require expensive or lifelong antiviral therapy leading to exorbitant healthcare cost. The central aim of this thesis is to discuss the elimination of disease and the burden of disease in the context of a curable disease (HCV) and chronic infection (HIV) and offer strategies which can reduce cost and/or increase health benefit. The following recommendations needs addressing in terms of the WHO and UNAIDS elimination goals. First, immediate DAA treatment should become available for all HCV-infected patients. Second, monitoring and screening strategies should be population specific based on epidemiology, risk behaviour, and available resources. Third, surveillances tracking transmission and resistance should be in place guiding monitoring strategies and informing on DAA therapy regimens. Moreover, surveillances are important in terms of epidemic preparedness. Fourth, GP guidelines for HIV can be improved optimizing earlier HIV-case finding. Moreover, AI algorithms can identify risk factors or undiagnosed HIV infections from medical files. Fifth, integration and decentralization of care reduces cost, maximize efficiency, increases accessibility, and lowers barriers for care. Lastly, ensuring a good QoL is key in elimination of the burden of disease and should be adopted in care and as the ‘fourth 90’ of the UNAIDS goals. E-health is the next step in health care supporting current practices and the first step towards more personalised HIV-care.

Due to corona, the PhD defences do not take place publicly in the usual way in the Senate Hall or in the Professor Andries Querido Room. The candidates will defend their dissertation either in a small group or online.