Infectiology
My special HIV programme
As part of HIV therapy, we offer all analyzes in our program according to the guidelines: that we take care of the immune system, determine the associated values, the viral load – these are always buzzwords. But we also look at whether patients have problems taking their pills, whether they have side effects during therapy. It should be a long therapy, if possible without complications.
But we also offer other things: for example, communication with the AIDS organization or the gay counseling service. We arrange places for drug or psychotherapy. We make sure that everything goes smoothly in the context of the work environment, the psychosocial environment. The sick person can also come with all other things that at first glance have nothing to do with HIV, but which are simply important.
One to one HIV Therapy
“One to one care” is very important to us in HIV therapy, because you build up a very personal connection to your doctor, or the doctor to his patient. By constantly changing doctors, where you have to tell your story again and again, at some point the patient no longer trusts the doctor. It is therefore absolutely essential for us that we see each patient “one to one”. If it’s a small matter, the patient can of course also be seen by the doctor in training.
HIV Patients in my practice
HIV patients come to our practice because they appreciate the personal care. You always meet me here, you can turn to us with any problem, no matter what it is.
We are unprejudiced, just accompany and the more we know about someone – what drugs they take, what STDs they have, what they do at work, what psychological problems they have, whether they can’t cope with taking the pills – no matter what question , we answer them and try to build up long-term care together with the patient.
HIV therapy & sexual behaviour
HIV and sexual intercourse is an important issue for HIV patients because they mostly contracted it through “unprotected sexual intercourse”. In order to have safe sex in the future, even without a condom, with responsibility and without a guilty conscience……
…. some questions arise:
- Can I still superinfect myself with another virus?
- How can I protect other people?
- How can I protect myself?
- How long am I contagious?
In this context, the HIV patient may simply have other sexual infections more frequently. It’s important to talk about it, you have to know it, you also have to pass on information. The patient must always have the feeling, no matter what symptom he comes to me with, that we talk openly about it and treat it.
That leaves my message for the people:
“Come with everything you have.”
Gaps in HIV therapy
What we often lacked in other programs is that only the values of the HIV patient are looked at. We missed the whole package. An overall concept HIV.
We do it differently in practice now – we put the patients on the bicycle ergometer to see if the heart is in order. We do regular lung function tests , we use a special technique to check whether the back of the eye is okay. The annual organ check using ultrasound is part of this, as many medications are excreted via the liver and kidneys.
Since the body composition of our HIV patients is important to us, we offer you this examination ( Inbody 970 ) once a quarter free of charge. More than 70 different values are collected here.
From this we develop an individual overall concept so that the patient is really perceived as a whole over many years and that we also discover all the collateral damage – through smoking, poor nutrition, little exercise – and have an answer for it – and we directly for the patient put together an individual programme.
Hepatitis B and C
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.
The modern DAA therapy (direct antiviral agent)
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.
DAA therapies – their individual drug classes
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)
Sexually Transmitted Diseases
Our practice offers diagnostics and treatment of symptomatic sexually transmitted infections (STIs)
If symptoms of an STI exist, such as discharge, burning when urinating, accumulation of mucus/blood when having a bowel movement, please come directly to the acute consultation between 9 a.m. and 11 a.m.
- Hepatitis B and C
- syphilis
- gonorrhea
- chlamydia
- mycoplasma
We ask patients with private health insurance to do so in advance Clarify with your health insurance company which costs will be covered (clarify any personal contributions and deductibles). We calculate you as a practice, the medical services and basic laboratory services according to the fee schedule for doctors (GOÄ). In addition, you will directly receive a GOÄ invoice for this Special laboratory from our laboratory, the contact for this is the laboratory.
PrEP Clinic Berlin
PrEP is you you
free
Check your Risk:
Play Safe – and book your PrEP appointment today – be protected
meet our doctors and get your PrEP prescription.
PrEP will be available from 01.09.2019
- I am a gay or bisexual man
- I am HIV negative but my partner is positive
- I am a Sex worker (AOK)
- I am a drug user
- I only have sex without a condom (individual risk assessment)
FAQ
Before you make an appointment in our practice to learn more about PrEP, please read the most frequently asked questions and their answers below.
Make an appointment with our doctors and you will receive a PrEP prescription directly.
From 01.09.2019 onwards, you will receive the medicine as prescribed by the health insurance company.
Not all private health insurance companies reimburse for PrEP. Please keep the receipt for the PrEP from the pharmacy, as we assume that other health insurance companies will also reimburse the PrEP.
Other ways of obtaining Truvada or generic drugs (e.g. abroad or on the black market) may be risky and are NOT recommended by us.
The PrEP is still available through a normal private prescription from 40 Euros per 28 tablets. PrEP can only be prescribed by HIV specialists.
PrEP is the abbreviation for pre-exposure prophylaxis and is a protection against infection through medication before having sex with HIV. PrEP consists of the two drugs Tenofovir (TDF) and Emtricitabine (FTC). This drug is the only proven effective drug for PrEP. It is available in Germany as an original but also as a generic drug.
The PrEP drug contains two active ingredients that prevent the cells from multiplying in the body. If the virus gets into the cells of mucous membranes or the immune system during sex without a condom, it cannot multiply there. In this way, an infection can be prevented, and you remain negative – even though individual body cells have already been infected.
Its effectiveness has been proven in trials with gay men who are at particularly high risk of HIV. These are men who have sex frequently and who find it difficult to use condoms. PrEP could also work for heterosexual men or women. However, the studies so far do not provide such convincing success data. Protection often failed because the participants did not take PrEP regularly.
In 2015, the “Ipergay” and “PROUD” studies showed an 86 percent reduction in the risk of transmission among gay men. Overall, the protection is over 90%. In other words: in the group of men who took the PrEP, there were only a good tenth of the infections that would otherwise exist without PrEP. PrEP thus has a similarly high protective effect against HIV as condoms. Regular use is crucial to its effectiveness. PrEP is not a suitable method for people who have difficulty taking tablets in a disciplined way.
PrEP is approved in Germany for permanent PrEP, i.e. you take one tablet a day.
Most people tolerate PrEP well and feel little or no side effects. Some users complain of nausea, diarrhoea, headaches, stomach and joint pain, as well as tiredness or sleep disturbances. Taking PrEP over a long period of time can reduce kidney function in the very unlikely event. Normally, this reduced function will disappear after stopping PrEP. This is not a relevant problem for healthy people, but who knows how well their kidneys are performing? That is why you need to check your kidney function before starting PrEP and then every 3 months. People who suffer from kidney disease should not take PrEP.
You will immediately receive PrEP from us, even if you have had condomless sex (fucking, fisting) or other risky situations (e.g. chemsex) in the last 4 weeks. To make sure you are as safe as possible, we repeat the HIV test 4 weeks later to rule out an HIV infection that was not detectable at the beginning of the PrEP (the diagnostic window only starts after 4 weeks).
No. PrEP does not provide protection against syphilis, gonorrhoea, chlamydia and hepatitis C. You may experience increased STIs and the risk of contracting hepatitis C increases.
If the PrEP is not taken properly, HIV infection can occur. If the infection is then not detected quickly, HIV can become resistant (insensitive) to PrEP. The medicine can then no longer be used to treat the HIV infection. It is therefore important to have an HIV test immediately before starting PrEP and at least every 3 months thereafter.
As of 01.05.2019, AOK insured persons can prescribe the medication from a health insurance prescription retroactively.
All others with statutory health insurance still receive a private prescription. Please keep the receipt for the PrEP in your pharmacy, as we assume that other health insurance companies will also reimburse the PrEP retroactively.
From 01.09.2019 onwards, you will receive the medicine prescribed on a prescription from the health insurance company.
Not all private health insurance companies will reimburse the PrEP. Please keep the receipt for the PrEP from the pharmacy, as we assume that other health insurance companies will also reimburse the PrEP.
Other ways of obtaining Truvada or generic drugs (e.g. abroad or on the black market) may be risky and are NOT recommended by us.
The PrEP is still available through a normal private prescription from 40 Euros per 28 tablets. PrEP can only be prescribed by HIV specialists.
