By Zach Tanner
CANOC Announces Research Expansion in Saskatchewan to Help Address the Province’s Disproportionate Burden of HIV
The Canadian Observational Cohort (CANOC) – the largest Canadian database of HIV-positive individuals on highly active antiretroviral therapy (HAART), representing over 10,000 people – has since 2008 analyzed clinical and demographic data from across eight cohort sites in British Columbia, Ontario and Quebec. The CANOC collaboration, led by Dr. Robert Hogg of the British Columbia Centre for Excellence in HIV/AIDS (BC-CfE), is pleased to announce its expansion to a site in Saskatchewan. Since 2004, Saskatchewan has seen alarming spikes in new HIV cases but is often overlooked in national HIV research.
Drawn from over 400 patients in the clinical database of the Regina Qu’Appelle Health Region Infectious Diseases Clinic (RQHR IDC), the Regina Qu’Appelle HIV Cohort (RQHC) will provide crucial information about HIV in Saskatchewan. The cohort is the first of its kind in the province. It will provide a framework for future expansion and valuable insights into gaps in treatment, outcomes, and risk factors that will enable the RQHR IDC and its partners to improve HIV care.
When added to CANOC’s interprovincial database, the Regina-based cohort will provide a much-needed depiction of the particular demographic, social, and clinical characteristics that define Saskatchewan’s HIV-positive population on HAART. Moreover, it will enhance CANOC’s national representation of people living with HIV in Canada, in a significant step towards enriching understanding of HIV treatment outcomes and regional trends.
“We’re very pleased we have been able to establish a robust electronic clinical and data infrastructure in our clinic,” explains Dr. Alexander Wong, the Principal Investigator responsible for overseeing the RQHC and its association with CANOC. “It was a lot of hard work by the team to get things up and running, but now we have the real-time systems in place to participate in clinical research and most importantly allow our team to provide the best possible care for our patients. We’re very excited to be able to join CANOC and contribute to this important national collaborative.”
Currently, 2.4% of HIV-infected Canadians are living in Saskatchewan, compared to 18.8% in British Columbia, 43.8% in Ontario, and 22.4% in Quebec. But the province is in the midst of a unique HIV epidemic, which is disproportionately affecting Aboriginals and is driven by the use of injection drugs. Saskatchewan now has the highest incidence rate of HIV infection within Canada.
Spikes in new HIV diagnoses began appearing in Saskatchewan in 2004. By 2009, the epidemic peaked at 19.2 cases per 100,000, comparable with HIV incidence rates in Nigeria. Incidence rates in 2012 were at 17.0 cases per 100,000 in 2012. By comparison, the 2012 rates of HIV-positive test reports for BC, Ontario, and Quebec were 5.1, 6.2, and 5.6, respectively. In a positive development, the number of new HIV diagnoses in Saskatchewan fell to 129 in 2013, or 11.5 per 100,000 – still significantly above other provinces.
The RQHR IDC located at the Regina General Hospital falls under the Saskatchewan Ministry of Health’s four-year provincial HIV strategy launched in 2010. Staff at the referral centre includes nurses, pharmacists, social workers, dieticians, and physicians providing comprehensive social and medical care to HIV-infected individuals.
Reflective of the current HIV epidemic in the province, the majority of patients in the clinic’s cohort are male, Aboriginal, have a history of injection drug use, and are between the ages of 26 and 55. Ongoing investigation of the unique Regina-based cohort will help fill in knowledge gaps and identify specific barriers associated with this group’s reported lower antiretroviral treatment uptake and adherence. Moreover, this research will help identify how HIV treatment outcomes diverge between these and other at-risk groups, and will improve the dissemination of this information to policymakers, health care provider, and researchers.