In the context of HIV therapy, I offer the usual things here in my programme according to the guidelines: that we take care of the immune system, determine the corresponding values, the viral load – these are always key words. But we also look at whether patients have problems taking their pills, whether they have side effects from the therapy. It should be a long therapy, if possible without complications.
“One to one care” is very important to me in HIV therapy, because you build up a very personal connection to your doctor, or the doctor to his patient. Due to constant changes of doctors, where you have to tell your story over and over again, the patient at some point no longer trusts the doctor. Therefore it is absolutely essential for me to see every patient “one to one”. If it’s a small thing, the patient can of course also go to a colleague. But basically, I do everything.
HIV patients come to my practice because they appreciate the personal care. They always meet me here, they can turn to me with any problem, no matter what it is.
HIV and sexual intercourse is an important issue for HIV patients because they have mostly become infected through unprotected sexual intercourse and are likely to continue to practice it.
In this context, the HIV patient simply has other sexually transmitted diseases more often. It is important to talk about it, you have to know about it, you also have to pass on information. The patient must always have the feeling, no matter what symptom he comes to me with, we talk about it openly and treat it.
What I have often missed in other programmes is that HIV patients are only looked at their values. I missed the whole package.
Dr. Ochlast is a member of the Deutschen Leberstiftung e.V. and the Europäischen Vereinigung zur Studie der Leber (EASL).
In the care of our patients, we place special emphasis on individual psychosocial support. Before, during and after the therapy you will be accompanied by our social worker/social pedagogue Michael Pesendorfer.
We carefully plan each individual therapy in cooperation with the head physician Chefarzt Prof. Dr. med. Ulrich Böcker, M.A., FEBG,
Clinic for Gastroenterology and Diabetology, Vivantes Klinikum Neuköln. HIV infection is not a factor here.
Since the beginning of 2015, we have had several new drugs available in the field of hepatitis C to cure patients interferon-free of the infection. The chances of cure are in the 90-100% range.
For all patients without pre-treatment with the more modern drugs and without cirrhosis, the therapy can be limited to 8 weeks. An HIV infection is not important here.
DAA therapy is an interferon-free therapy consisting of a combination of the preparations listed below. The combination with ribavirin is still partly necessary. A major advantage of these therapy combinations is the significantly lower side effect profile and the possibility of using these therapies even if there are contraindications for interferon. The combination of 2 or 3 of different classes of active substances even makes it possible to do without ribavirin, as this drug is responsible for poor physical condition and anaemia.
I. Protease inhibitors (word ending on “-previr”)
These drugs have been available to us for several years with the 1st generation (Boceprivir and Telaprivir). The 1st generation drugs are no longer recommended as 1st line therapy by the medical associations. 2nd generation “-“previrs”, i.e. a further development of the drugs already available to us, they are characterised by a significantly better efficacy profile (cure rates between 90 and 100%). No significant side effects have been reported.
At present, the following drugs are officially available in Germany: Glecaprevir (Maviret® in combination with Pribrentasvir), Voxilaprevir (Vosevi® in combination with Ledipasvir / Velpatasvir), Simeprivir (Olyseo®), Pariatrivir (Viekirax® – in combination with Ombitasvir/r) and Grazeprevir (Zepatier® – in combination with Elbasvir).
Other very promising compounds such as voxilaprevir are in clinical trials, which even offer healing options to patients who have failed on previous interferon-free therapy.
II. polymerase inhibitors (word ending on “-buvir”)
These drugs block the RNA polymerase of the hepatitis C virus, thereby preventing the hepatitis C RNA from “copying”. The “-buvirs” are a good combination partner in interferon-free therapy. They act on all hepatitis C genotypes.
At present, we officially have Sofosbuvir (Sovaldi®, in Harvoni®, in Epclusa®) and Dasabuvir (Exviera®) available in Germany.
III. NS5a inhibitors (word ending on “-asvir”)
These drugs also intervene in the “copying” of hepatitis C RNA. They are highly effective and have few side effects. The “-asvirs” are good combination partners in interferon-free therapy.
At present, we officially have pibrentasvir (Maviret®- in combination with glecaprevir), daclatasvir (Daklinza®), ledipasvir (Harvoni®- in combination with sofosbuvir) in Germany, Ombitasvir (Viekirax® – in combination with Pariatrevir/r), Velpatasvir (Epclusa®- in combination with Sofosbuvir, Vosevi®, in combination with Sofosbuvir /Voxilaprevir) and Elbasvir (Zepatier® – in combination with Grazoprevir)
Our practice offers diagnostics and treatment of symptomatic sexually transmitted infections (STIs)
Patients with private health insurance are kindly requested to clarify with their health insurance company in advance which costs will be covered or whether you have booked the right insurance tariff for you (e.g. high deductible). As a practice, we will charge you for the medical services and basic laboratory services according to the scale of fees for doctors (GOÄ). In addition, you will receive a GOÄ invoice directly from our laboratory via the special laboratory, the contact person for this is the laboratory. Anonymous tests (e.g. before taking out insurance etc.) are also possible as a self-payer.