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!
New study: How does Europe become a leading player for software and IT services?
03.04.2017 | Fraunhofer-Institut für System- und Innovationsforschung (ISI)
Reusable carbon nanotubes could be the water filter of the future, says RIT study
30.03.2017 | Rochester Institute of Technology
Staphylococcus aureus is a feared pathogen (MRSA, multi-resistant S. aureus) due to frequent resistances against many antibiotics, especially in hospital infections. Researchers at the Paul-Ehrlich-Institut have identified immunological processes that prevent a successful immune response directed against the pathogenic agent. The delivery of bacterial proteins with RNA adjuvant or messenger RNA (mRNA) into immune cells allows the re-direction of the immune response towards an active defense against S. aureus. This could be of significant importance for the development of an effective vaccine. PLOS Pathogens has published these research results online on 25 May 2017.
Staphylococcus aureus (S. aureus) is a bacterium that colonizes by far more than half of the skin and the mucosa of adults, usually without causing infections....
Physicists from the University of Würzburg are capable of generating identical looking single light particles at the push of a button. Two new studies now demonstrate the potential this method holds.
The quantum computer has fuelled the imagination of scientists for decades: It is based on fundamentally different phenomena than a conventional computer....
An international team of physicists has monitored the scattering behaviour of electrons in a non-conducting material in real-time. Their insights could be beneficial for radiotherapy.
We can refer to electrons in non-conducting materials as ‘sluggish’. Typically, they remain fixed in a location, deep inside an atomic composite. It is hence...
Two-dimensional magnetic structures are regarded as a promising material for new types of data storage, since the magnetic properties of individual molecular building blocks can be investigated and modified. For the first time, researchers have now produced a wafer-thin ferrimagnet, in which molecules with different magnetic centers arrange themselves on a gold surface to form a checkerboard pattern. Scientists at the Swiss Nanoscience Institute at the University of Basel and the Paul Scherrer Institute published their findings in the journal Nature Communications.
Ferrimagnets are composed of two centers which are magnetized at different strengths and point in opposing directions. Two-dimensional, quasi-flat ferrimagnets...
An Australian-Chinese research team has created the world's thinnest hologram, paving the way towards the integration of 3D holography into everyday...
24.05.2017 | Event News
23.05.2017 | Event News
22.05.2017 | Event News
26.05.2017 | Life Sciences
26.05.2017 | Life Sciences
26.05.2017 | Physics and Astronomy