B.C. treatment protocol reduces HIV infection rates, study says
Published Tuesday, November 27, 2012 5:01PM EST
Last Updated Tuesday, November 27, 2012 11:39PM EST
A British Columbia program that makes antiretroviral therapy more widely available to HIV patients is leading to a marked decrease in the number of new infections in the province, according to new research. The study says the model should be rolled out across Canada, or the number of HIV cases across the country will likely double over the next 15 years.
The study, led by researchers from B.C. and published Tuesday in the journal PLOS One, compiled data on HIV infections and mortality rates from 1995 to 2008. It also took into account how widely available HAART, or highly active antiretroviral therapy, is across Canada.
HAART is a treatment program of medications that reduce HIV in the bloodstream to undetectable levels, which both improves the patient’s overall health and helps reduce the risk of the virus’s transmission.
The researchers found that for every 10 per cent increase in HAART coverage, the rate of new HIV diagnoses dropped by eight per cent in B.C., Ontario and Quebec. More than 86 per cent of Canadians living with HIV reside in those three provinces.
The study also found that B.C. had the largest decrease in new HIV infections over the study period, from 18.05 per 100,000 population to 7.94. HIV infection rates remained steady across much of the rest of the country, except in the Prairies, which saw a four-fold increase in new diagnoses, a surge led by Saskatchewan.
The province also averted more HIV cases than both Ontario and Quebec combined, 10.33 cases per 100,000 compared to 3.40 and 0.33 for Ontario and Quebec, respectively.
Senior study author Dr. Julio Montaner is director of the BC-Centre for Excellence in HIV/AIDS and head of the division of AIDS at the University of British Columbia’s faculty of medicine. He said the findings show a “dramatic decrease” in new HIV infections in a province where rigorous testing and treatment protocols are in place.
HAART is free for all HIV patients in B.C., where a unique protocol was developed called Treatment as Prevention. The program involves widespread testing and quick implementation of treatment with HAART drugs for patients with HIV.
“B.C. is indeed the only region in the country where the number of new diagnoses has declined significantly over the last two decades, and not by a trivial amount,’ Montaner told CTV News. “We have a decrease of over 60 per cent, which means not only saving lives and preventing disease, but we are also saving money.”
Montaner and his colleagues are calling for a national treatment strategy “so we can truly deliver on the dream of an AIDS-free generation.”
Montaner and colleagues are specifically calling for the expansion of B.C.’s unique program.
Montaner said the study proves the model’s success at treating and preventing disease.
“Prevention gives us a unique opportunity to virtually eliminate HIV from Canada and in doing so showing the world that it can be done,” Montaner said.
Walter Hiebert was diagnosed with HIV 24 years ago and began HAART treatment in 1996. When he was diagnosed, he was given just six months to live. Friends died from the disease.
“When I got the call and I heard the person say, ‘you have tested positive,’ I just basically froze and became extremely anxious and cried,” Hiebert told CTV.
“It was a total death sentence.”
After treatment, Hiebert, now 56, was able to return to school and then work. He is a critical care nurse in Vancouver, and credits treatment with saving his life.
“The biggest thing in my head was that finally I had control of this virus,” Hiebert said. “When you are on the medications, you finally take control of your life back.”
Dr. Perry Kendall, B.C.’s provincial health officer, said without a national strategy, “we will see an ongoing increase in the people who have HIV and AIDS.” Approximately 3,300 new cases of HIV are diagnosed in Canada every year.
“I actually think we have a moral and ethical obligation to do what we can to prevent further infections, and to improve the lives and the health of people who are currently infected,” Kendall said.
Kendall said the Treatment as Prevention program has also helped reduce the number of HIV infections among hard-to-reach populations, such as injection drug users.
“If you can get HIV rates down in this really hard-to-reach population, it is very significant,” Kendall said. “The same population in other parts of Canada, in the Prairies, are where we are seeing new infections every week. So there are lessons to be learned.”
With a report from CTV’s medical specialist Avis Favaro and producer Elizabeth St. Philip