The Expert Advisory Group on AIDS (EAGA) held its 66th meeting on the 15 November 2001. At that meeting the following items were discussed:
EAGA received an update on the work of the joint EAGA/UKAP Working Group and the criteria setting subgroup which both met during October 2001. EAGA endorsed a change in policy to selective patient notification following a risk assessment after identification of an HIV-infected health care worker, as recommended by the joint Working Group. Further work on developing revised guidance would be taken forward by the joint EAGA/UKAP Working Group.
Men who have ever had sex with another man are currently asked not to donate blood, i.e. to self-defer. Members discussed at some length an analysis of the effects of relaxing this deferral criterion on the safety of the blood supply. The decision to maintain the status quo and to keep all the criteria under review was taken elsewhere (by the Advisory Committee on the Microbiological Safety of Blood and Tissues for Transplantation). It was agreed that the authors of the analysis would meet with organisations representing both the donors affected by the deferral criteria and patients (recipients) in order to inform the next review of the blood donor deferral criteria.
EAGA learned that the generic and HIV-specific standards on which they had commented previously would shortly be posted on the UK National Screening Committee's website for consultation. At EAGA's request, a specific question about whether women arriving in labour should be offered an HIV test was to be included as part of the consultation process, as opinion was divided as to the acceptability and feasibility of this practice.
The Group was asked to consider whether the recently issuedHIV and Infant Feedingguidance should be amended to strengthen the advice to avoid breastfeeding for HIV-positive women newly arrived from abroad. It had been suggested that poor nutritional status among new arrivals might make breastfeeding a particular risk to their own health. While EAGA were content to leave the guidance unchanged, they agreed to keep the research under review.
Members received a report on the rising demands on the voluntary sector for provision of social health care for people affected by HIV. It was agreed that the report should be updated and its scope broadened to reflect HIV promotion work undertaken by the major voluntary sector organisations. The next step would be to submit this as part of the feedback on the National Strategy for Sexual Health and HIV consultation.
A presentation was given by the Head of the PHLS's Antiretroviral Susceptibility Reference Unit covering drug resistance in patients on treatment for HIV infection and in untreated seroconverters. The continued upward trend in the proportion of seroconverters infected with resistant virus was of concern as individuals on treatment are infecting others through unsafe sex.
At the request of the Joint Committee on Vaccination and Immunisation (JCVI), EAGA reviewed the current recommendation for pneumococcal vaccination in individuals with HIV infection. Their comments would be fed back to the JCVI to assist in the ongoing revision of the DH guidanceImmunisation against infectious disease.
EAGA concluded its review of the Unlinked Anonymous Programme. They commended the programme as an important component of HIV surveillance. It provided essential public health information, which was used, for policy on HIV and as part of the evidence base, which could not be obtained by any other means. Members welcomed the steps outlined for raising awareness of the public health value of the surveys at participating clinics.
EAGA received an update on the work of the Working Group, which had been reconvened to address the issue of offering post-exposure prophylaxis to patients in the unlikely event of an infected health care worker bleeding into a patient's open wound. It was agreed that the membership of the Group would be widened to include representation from a patient organisation and the voluntary sector.
EAGA was updated on the HIV/AIDS related work of UKAP.
The consultation on the Strategy would run until 21 December and a number of nation-wide consultation events were to be held during this period.
1. Terms of Reference of the Expert Advisory Group on AIDS:
The Expert Advisory Group on AIDS (EAGA) is an advisory non-departmental public body which is non-statutory. It was established in 1985 "To provide advice on such matters relating to AIDS as may be referred to it by the Chief Medical Officers of the Health Departments of the United Kingdom"
. The Group meets three times a year and there have been 66 meetings to date. It currently has 21 members. Fixed terms of office are for three years and no member should serve more than two three-year terms. The Group has agreed to publish summary reports of meetings in the interests of openness and transparency.
2. Membership of EAGA: