A comprehensive population-based study, conducted by the BC Centre for Excellence in HIV/AIDS (BC-CfE) and presented at the 17th Conference on Retroviruses and Opportunistic Infections in San Francisco, shows that expanded highly active antiretroviral therapy (HAART) coverage was associated with a 50% decrease in new yearly HIV infections among injection drug users.
These results were temporally related to an outreach effort specifically targeting injection drug users. In addition, increased HAART coverage was associated with a decrease in the community HIV plasma viral load in British Columbia.
Providing HAART treatment to HIV-infected drug users has been strongly debated by researchers and clinicians. Some argue that social instability related to illicit drug use can compromise HAART-related benefits. As a result, on a global scale, drug users have been less likely to be prescribed HAART and are consequently more likely to have worse health outcomes, including higher rates of HIV disease progression to AIDS and death.
But the BC-CfE's study results point to the effectiveness of HAART in providing life-supporting benefits to all HIV-infected people, including those in marginalized communities such as injection drug users. A previous BC-CfE study showed that five-year mortality is similar between HIV-infected injection drug users and non-users infected with HIV and treated with HAART. Today's results show that HAART's secondary benefit of HIV prevention will also be realized among drug users.
"Our results clearly reveal the need to develop specific initiatives to increase HAART coverage among injection drug users," said Dr. Julio Montaner, Director, BC-CfE, and an early proponent of expanding HAART coverage as a way to decrease progression to AIDS and death in HIV-infected individuals and to prevent HIV infections among individuals at risk.
Based on HAART's proven efficacy and results from studies at the BC-CfE, the British Columbia government has announced a new C$48-million, four-year initiative to enhance HAART outreach to hard-to-reach populations in B.C., including injection drug users. This builds on the earlier developmental funding ($2.5 million over five years) provided by the National Institutes of Drug Abuse at the U.S. National Institutes of Health and the Knowledge Translation Award (C$100,000) from the Canadian Institutes of Health Research.
The project, known as Seek and Treat to Optimize Prevention of HIV and AIDS (STOP HIV & AIDS), is aimed at curbing the transmission of HIV and decreasing AIDS-related morbidity and mortality. These benefits will occur by expanding HIV treatment, care and support, as well as improving access to HIV drugs for hard-to-reach residents. The pilot project will focus on Prince George and Vancouver's Downtown Eastside, where access to services remains sub-optimal.
As part of this initiative, specific efforts will be made to identify and test individuals at risk (seek) and engage them in care and on HAART if medically appropriate (treat), all within a supportive environment that includes harm reduction strategies. Medical care, laboratory monitoring and HAART are all available free of charge as part of the universal health care system in B.C.
The results of the BC-CfE's study come at a key time, given concerns raised by a recent mathematical model based on the San Francisco experience published by Smith et al (Science, January 14, 2010). The study conducted in San Francisco suggested that the effectiveness of increased HAART coverage could be seriously undermined by the emergence of an epidemic of drug-resistant HIV.
"However, our population-based results collected over the last decade demonstrate that high levels of sustained viral suppression can be achieved and the emergence of drug-resistant HIV can be prevented through the appropriate use of modern antiretroviral regimens as currently recommended by the World Health Organization (WHO) coupled with adequate patient support. These lessons are keys to the roll out of HAART around the world," said Montaner, who is Professor of Medicine, Chair of AIDS Research and Head of the Division of AIDS at the University of British Columbia.
About the B.C. Centre for Excellence in HIV/AIDS:
The BC Centre for Excellence in HIV/AIDS (BC-CfE) is Canada's largest HIV/AIDS research, treatment and education facility. The BC-CfE is based at St Paul's Hospital, Providence Health Care, and a teaching hospital of the University of British Columbia. Located in Vancouver, Canada, the BC-CfE is dedicated to improving the health of British Columbians with HIV through the development, monitoring and dissemination of comprehensive research and treatment programs for HIV and related diseases.
Brian Lin | EurekAlert!
Rutgers-led innovation could spur faster, cheaper, nano-based manufacturing
14.02.2018 | Rutgers University
New study from the University of Halle: How climate change alters plant growth
12.01.2018 | Martin-Luther-Universität Halle-Wittenberg
A newly developed laser technology has enabled physicists in the Laboratory for Attosecond Physics (jointly run by LMU Munich and the Max Planck Institute of Quantum Optics) to generate attosecond bursts of high-energy photons of unprecedented intensity. This has made it possible to observe the interaction of multiple photons in a single such pulse with electrons in the inner orbital shell of an atom.
In order to observe the ultrafast electron motion in the inner shells of atoms with short light pulses, the pulses must not only be ultrashort, but very...
A group of researchers led by Andrea Cavalleri at the Max Planck Institute for Structure and Dynamics of Matter (MPSD) in Hamburg has demonstrated a new method enabling precise measurements of the interatomic forces that hold crystalline solids together. The paper Probing the Interatomic Potential of Solids by Strong-Field Nonlinear Phononics, published online in Nature, explains how a terahertz-frequency laser pulse can drive very large deformations of the crystal.
By measuring the highly unusual atomic trajectories under extreme electromagnetic transients, the MPSD group could reconstruct how rigid the atomic bonds are...
Quantum computers may one day solve algorithmic problems which even the biggest supercomputers today can’t manage. But how do you test a quantum computer to...
For the first time, a team of researchers at the Max-Planck Institute (MPI) for Polymer Research in Mainz, Germany, has succeeded in making an integrated circuit (IC) from just a monolayer of a semiconducting polymer via a bottom-up, self-assembly approach.
In the self-assembly process, the semiconducting polymer arranges itself into an ordered monolayer in a transistor. The transistors are binary switches used...
Breakthrough provides a new concept of the design of molecular motors, sensors and electricity generators at nanoscale
Researchers from the Institute of Organic Chemistry and Biochemistry of the CAS (IOCB Prague), Institute of Physics of the CAS (IP CAS) and Palacký University...
15.02.2018 | Event News
13.02.2018 | Event News
12.02.2018 | Event News
23.02.2018 | Physics and Astronomy
23.02.2018 | Health and Medicine
23.02.2018 | Physics and Astronomy