Prof. Matthias CAVASSINI

HIV diagnosis

This is the first step to HIV care and despite the availability of very accurate, cheap, and fast testing diagnostic kits, the modern world is still facing an unacceptable high rate of late diagnosis (in Switzerland around 50 % of new diagnosis have less than 350 CD4 cells/mm³ at diagnosis). Over the last years, we have answered the following questions: How often do patients think that they had an HIV test performed on a routine basis prior to an elective surgery or in the emergency department? What is the rate of HIV testing in different services of a teaching hospital? Are physicians aware of the national HIV testing guidelines? If the physicians are aware of the guidelines, does it impact favorably the rate of HIV testing? What are the barriers to HIV testing from the patient’s perspective and the physician’s perspective?

Switzerland aims at “zero new HIV infection by 2030”, our next challenge is to implement Opt-out HIV testing practice, to make sure no-one is left without treatment.

Adherence and pharmacological studies

Ask HIV physicians, what is the most important factor for long term antiretroviral success? I would not be surprised if more than 90 % of them answer: “access and adherence to HIV treatment and care”. We had the privilege to work over the last 15 years in close collaboration with our hospital pharmacy. We can analyze the impact of a pharmacy-based adherence clinic and increase our understanding on long term adherence data through the use of electronic monitoring. In addition, we also collaborate with the pharmacological laboratory that measures HIV drug levels and is able to investigate plasma drug levels, free drug concentrations and various drug interactions.

Neurocognitive disorders in People with HIV

As HIV has become a chronic disease, we see in our clinic more diseases associated with aging. Bone diseases, renal diseases, cardiovascular, oncologic diseases and minor dementia are among the most frequently cited in the literature. Whether the latter is more prevalent among People living with HIV remains a matter of debate. Along with Prof Renaud Du Pasquier (neurologist), We decided to create a sub-cohort within the Swiss HIV Cohort Study.  More than 950 patients have been included and contribute to a better understanding of factors associated with cognitive disorders as well as the outcome over a 4 years period of their cognition.

Other

Stigma, cardiovasc. dis., HIV treatment, Hepatitis E virus,  Swiss HIV Cohort Studies (www.shcs.ch)