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!
Smart Data Transformation – Surfing the Big Wave
02.12.2016 | Fraunhofer-Institut für Angewandte Informationstechnik FIT
Climate change could outpace EPA Lake Champlain protections
18.11.2016 | University of Vermont
In recent years, lasers with ultrashort pulses (USP) down to the femtosecond range have become established on an industrial scale. They could advance some applications with the much-lauded “cold ablation” – if that meant they would then achieve more throughput. A new generation of process engineering that will address this issue in particular will be discussed at the “4th UKP Workshop – Ultrafast Laser Technology” in April 2017.
Even back in the 1990s, scientists were comparing materials processing with nanosecond, picosecond and femtosesecond pulses. The result was surprising:...
Have you ever wondered how you see the world? Vision is about photons of light, which are packets of energy, interacting with the atoms or molecules in what...
A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.
Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...
In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.
“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...
The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.
The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...
16.11.2016 | Event News
01.11.2016 | Event News
14.10.2016 | Event News
07.12.2016 | Materials Sciences
06.12.2016 | Materials Sciences
06.12.2016 | Medical Engineering