PhD research by Patrick Oomen (UMC Utrecht) revealed that there may be remarkable differences in research outcomes between formal clinical trials and real-world settings. In this context, it remains important to include real-world outcomes to continue to optimize HIV care to enhance the quality of life for those living with HIV.

Over 40 years ago, the world witnessed the start of a global health crisis unprecedented in history: the Human Immunodeficiency Virus (HIV) epidemic. The first 15 years were marked by significant setbacks and difficult progress in the treatment of HIV. However, a turning point came with the advent of combination antiretroviral therapy (cART). Currently, people with HIV on cART experience minimal side effects, and cART is remarkably effective in suppressing HIV. These advances in ART now allow for an expanded perspective. In his PhD thesis, Patrick Oomen, MD (Department of Infectious Diseases, UMC Utrecht) presented several studies dedicated to optimizing treatment and monitoring of both HIV and HIV-associated co-morbidities beyond virologic suppression. The goal was to optimize the treatment and monitoring of HIV and HIV-associated comorbidities.

In the first part his thesis, Patrick Oomen and colleagues delved into the real-world effectiveness and tolerability of doravirine-based ART, revealing it in a Dutch nationwide 2-year, matched case-control study to be well-tolerated and non-inferior to regimens that did not contain doravirine. In addition, a large cohort study on viral blips - a temporary elevation of plasma HIV viral load above the detection limit - uncovered associations with residual viremia and specific ART regimens. A mini-review explored the impact of different ART regimens on HIV-associated immune activation, suggesting insufficient evidence for the superiority of dual therapy over triple therapy in immune activation. Furthermore, in a study on cognitive function in people with HIV, neurocognitive effects of discontinuing efavirenz were examined. The study showed no significant improvement of functional MRI activation regarding reward processing and response inhibition.

In the second part of his thesis, he focused on HIV-associated comorbidities. A cross-sectional study found no long-term pulmonary impairment from past Pneumocystis jirovecii pneumonia (PJP) in people with HIV. Additionally, a quality improvement study identified gaps in hepatitis B virus (HBV) care, highlighting the need for improved screening and monitoring practices.

Patrick Oomen concluded: “Although the road to ending the HIV epidemic is still long and challenging, I believe that with continued effort and dedication, we can realize a future where HIV is no longer a global health crisis, but a manageable and controllable condition for those living with it.”

PhD defense

Patrick Oomen (1993, Delft) defended his PhD thesis on April 25, 2024 at Utrecht University. The title of his thesis was “HIV: Optimizing treatment and monitoring beyond virologic suppression”. Supervisor was Prof. Emer. Andy Hoepelman MD PhD (Department of Infectious Diseases, UMC Utrecht). Co-supervisor was Berend van Welzen MD PhD (Department of Rheumatology & Clinical Immunology, UMC Utrecht). In December 2023, Patrick started his training as a resident internal medicine at the Ziekenhuis Gelderse Vallei in Ede.