Nearly Half of Canadians Living with HIV Start Treatment Late

Vancouver, BC [October 5, 2015] HIV testing in parts of Canada remains based on “perceived risk” and could be keeping people living with the disease from discovering their status. A new study, based on the largest Canadian database of people living with HIV, finds nearly half of those surveyed started antiretroviral treatment (ART) when they had already reached an AIDS-defining illness or a weakened immune system.

The study found that:

From 2000 to 2012, 48% started ART with low CD4 counts, the indicator of a weakened immune system.
Focussing on the time period between 2008 and 2012, 68% of participants initiated ART when the immune system was already weakened.
Women, older adults, and individuals who inject drugs are among those more likely to start treatment late.
Over the study period, there was a shift towards earlier treatment initiation, reflective of more modern treatment guidelines and better treatment options.
“CD4 counts at ART initiation remain below treatment guidelines,” said Angela Cescon, a researcher with the BC Centre for Excellence in HIV/AIDS (BC-CfE), medical student, and lead author of the study. “Diagnosing patients at the earliest possible stage of HIV infection is critical to optimizing the benefits of HIV treatment.”

Early initiation of ART is essential to lowering the risk of HIV-associated illnesses, extending life expectancy and reducing onward HIV transmission. Under the Treatment as Prevention® strategy, pioneered at the BC-CfE, an individual will be offered HIV treatment immediately upon diagnosis. In September, the World Health Organization released new guidelines calling for the immediate treatment of all individuals diagnosed with HIV, regardless of CD4 count.

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Life Expectancy of People Living with HIV in Canada Now Reaches 65 Years of Age

Vancouver, BC [August, 7, 2015] A new study from the Canadian Observational Cohort (CANOC) Collaboration, housed at the BC Centre for Excellence in HIV/AIDS (BC-CfE), finds that the overall life expectancy of people living with HIV who have initiated antiretroviral therapy (ART) is 65 years of age. While findings from this study demonstrate a notable improvement in mortality outcomes since the early years of the HIV epidemic, life expectancy still remains below that of the general Canadian population.

“An HIV diagnosis is no longer the death sentence it once was, but we must continue to be vigilant in ensuring treatment is reaching everyone, particularly more vulnerable groups, such as injection drug users,” said Dr. Robert Hogg, Senior Scientist at the BC-CfE, and the Nominated Principal Investigator of the CANOC Collaboration. “We must be proactive and diligent in ensuring access testing and treatment where it is most needed.”

In this study, decreased life expectancy was observed for women, participants with a history of injection drug use, individuals with Aboriginal ancestry, and those initiating ART in earlier time periods. The gender-based differences in life expectancy observed in this analysis reflect previous findings the CANOC Collaboration, which has identified poorer HIV-related treatment outcomes among women compared to men.

This study also observed decreased life expectancy among participants initiating ART with CD4 counts lower than 350 cells/µl. This finding reinforces current BC-CfE treatment guidelines, which recommend that ART should be initiated for all people living with HIV regardless of CD4 count, to ensure the best long-term clinical response. Earlier this year, the landmark START study, a 35-country clinical trial funded by the National Institutes of Health (NIH), released findings strongly in support of early ART initiation regardless of CD4 cell count to reduce the risk of morbidity and mortality among people living with HIV.

Treatment as Prevention® (TasP®) is the concept of starting treatment immediately after an HIV diagnosis in order to reduce viral load – ensuring improved health of the patient and prevention of disease transmission. Dr. Julio Montaner, Director of the BC-CfE, pioneered the TasP® concept, which has been implemented in British Columbia, resulting in a steady and consistent decline in new HIV cases within the province.

“In light of previous research, it is not surprising these findings show early treatment is best, but it is critical to emphasize this research,” said Dr. Montaner. “Early ART initiation not only improves the health of people living with HIV, it also reduces onward transmission of the disease. Policymakers should support programs based on this science and provide widespread access to testing and treatment across Canada.”

This study used data from the Canadian Observational Cohort (CANOC) collaboration; the largest Canadian clinical cohort of people living with HIV on combination ART. The CANOC collaboration is an ongoing cohort study of over 10,000 people living with HIV/AIDS, across eight cohort sites in British Columbia, Ontario and Quebec. The CANOC Collaboration is funded by the Canadian Institutes of Health Research and brings together a diverse research team to conduct policy-relevant studies in HIV therapeutics, health services and population health. In an effort to become more nationally representative, the CANOC Collaboration has recently expanded into the provinces of Saskatchewan and Newfoundland.

About the Canadian Observational Cohort (CANOC) Collaborative Research Centre
CANOC focuses on HIV health services and epidemiologic cohort research. This national collaboration conducts policy-relevant studies in HIV therapeutics, population and public health. The CANOC Centre brings together a diverse team to capitalize on the unique and robust CANOC database, maximizing the quality and breadth of the health services and policy research generated. The Centre is funded by the Canadian Institutes of Health Research (CIHR) and the CIHR Canadian HIV Trials Network (CTN242).

About the British Columbia 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 and is internationally recognized as an innovative world leader in combating HIV/AIDS and related diseases. BC-CfE is based at St. Paul’s Hospital, Providence Health Care, a teaching hospital of the University of British Columbia. The BC-CfE works in close collaboration with key provincial stakeholders, including government, health authorities, health care providers, academics from other institutions, and the community to decrease the health burden of HIV and AIDS. By developing, monitoring and disseminating comprehensive research and treatment programs for HIV and related illnesses, the BC-CfE helps improve the health of British Columbians.

For additional information or to request interviews, please contact:
Caroline Dobuzinskis, BC-CfE
Phone: 604-682-2344 ext. 66536
Cell: 604-366-6540
Email: cdobuzin@cfenet.ubc.ca

CANOC Announces Research Expansion in Saskatchewan

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.

 

Organization Info:
For more information on CANOC, visit www.canoc.ca, or follow the CANOC Twitter Feed @CANOCResearch

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On World AIDS Day, Continued Research on HIV Remains Imperative

ICAD Closing the Gap – World AIDS Day Blog Post

1 December 2014

By Marina Irick

On World AIDS Day, Continued Research on HIV Remains Imperative
Researchers continue to uncover gaps in treatment

While there’s no question that World AIDS Day marks an opportunity to celebrate huge strides in fighting the HIV epidemic over the last three decades, complex questions remain about gaps in treatment access along lines of gender, race, geographic region, drug behaviour and age.

The Canadian Observational Cohort (CANOC) collaboration is an elite team of Canadian scientists exploring Canada’s largest database of HIV-positive individuals on modern antiretroviral therapy, led by Dr. Robert Hogg of the BC Centre for Excellence in HIV/AIDS (BC-CfE). The findings from one of the collaboration’s latest studies led by Dr. Hasina Samji has found gaps remaining in access to treatment for a number of groups in Canada.

Initiated in 2008 and headquartered at the BC-CfE, the CANOC study includes anonymized, encrypted health information on approximately 10,000 HIV-positive individuals over the age of 18 in BC, Ontario and Quebec.

The Canadian Observational Cohort (CANOC) research team’s most recent findings, published in the journal of HIV Medicine, found many groups had interruptions in treatment, including women, young people, those with Aboriginal ancestry, and drug and injection drug users. Other affected groups within the 7,633 Canadians living with HIV surveyed over an 11-year period for the study were those with less advanced disease and people living in the province of B.C.

The study found that, since 2006 research emerged showing grave health detriments of skipping HIV meds, much fewer patients now take “drug holidays” in the interest of possibly saving money or giving their bodies a break. Armed with new information, most HIV positive patients studied avoided stopping treatment. But some groups still face difficulty in keeping on treatment consistently. Understanding why that is and how their challenges can be addressed are essential tools to the fight against HIV.

“These findings bring to light patient groups that may be in need of extra support to stay on treatment.” said Dr. Hasina Samji, who led the CANOC study. “If we are to address the spread of HIV in an inclusive and far-reaching manner, we need to consider the treatment needs of all.”

Still other CANOC-based studies have highlighted gaps in HIV care and groups requiring special attention. Women were found to experience poorer responses to the treatment – measured by how quickly they suppress the virus or whether they have a viral rebound. There are also hurdles to overcome when it comes to treating youth in Canada with HIV. Although since 2000 fewer people are now starting therapy later than recommended by clinical guidelines, a high number of young adults (aged 18-30) in Canada are still starting treatment later than medically advised.

Such stoppages or delays in treatment are significant factors in the health of patients, but also in the spread of HIV. The BC-CfE, under the direction of Dr. Julio Montaner, has pioneered a Treatment as Prevention (TasP) strategy that has been implemented province-wide in B.C. The strategy is based on the notion that patients with HIV should as soon as possible be placed on highly active antiretroviral therapy, the game-changing drug cocktail now known as HAART. With early and consistent treatment, patients’ viral loads decrease dramatically – hugely mitigating the likelihood that they will spread the disease. The UN is now aiming to reduce the global AIDS pandemic by at least 90% of its 2010 rate by 2030 in a strategy based on TasP principles.

As we look forward to the future of HIV research and the goal of ending AIDS, research into treatment remains imperative. In the next five-year phase of the study, supported by the Canadian Institutes of Health Research (CIHR) and the CIHR Canadian HIV Trials Network, CANOC is looking to add participant data from clinics in Saskatchewan and Newfoundland to better reflect the epidemiology of Canada’s HIV epidemic from coast to coast. By bringing together frontline HIV physicians, epidemiologists, community organizations and investigators, decision makers, statisticians, graduate students, and data analysts, the CANOC study continues to unearth knowledge of great value to the national and worldwide battle against HIV.

 

Organization Info:
For more information on CANOC, visit www.canoc.ca, or follow the CANOC Twitter Feed @CANOCResearch

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Health research team awarded $2.7M for major study on HIV and aging

VANCOUVER – Dr. Robert Hogg, research scientist with the British Columbia Centre for Excellence in HIV/AIDS and professor in the faculty of Health Sciences at Simon Fraser University, and a team of investigators from across the country have been awarded a $2.7M grant from the Canadian Institutes of Health Research (CIHR) to expand Canada’s only longitudinal study of more than 10,000 HIV-positive individuals accessing antiretroviral therapy in Canada.

The study known as Canadian Observational Cohort (CANOC) Collaboration, has been examining data from patient databases across British Columbia, Ontario, and Quebec. The national research team has been studying regional differences in viral load testing between provinces, issues of co-infection with HIV and hepatitis C, and factors associated with late initiation of anti-retroviral treatment, among other clinically relevant topics. The team has identified a gap in national active surveillance of HIV disease and co-morbid conditions, and will use the new funding and resources to establish the CANOC Centre. New projects will assess the impact of HIV on aging-related co-morbidities, including cardiovascular disease, renal disease, liver disease and cancer, and also include new research teams and patient data from Saskatchewan.

“We are delighted to be able to continue the work established by the Canadian Observational Cohort Collaboration through the newly funded CIHR CANOC Centre,” says Dr. Robert Hogg, principal investigator of the CANOC Centre research team. “Our large and productive team of researchers will continue to monitor the impact and outcomes of modern anti-retroviral therapy (ART) on individuals living with HIV in the Canada, while exploring co-morbidities associated with aging on ART.”

The Centre will also provide new mentorship opportunities for students and community investigators.

“CANOC is well-situated to respond to future research questions related to the Canadian HIV/AIDS epidemic,” says Dr. Hogg. “Over the next five years, we will continue to gain valuable new insights into the long-term effects of antiretroviral therapy in people living with HIV.”

–30–

About the British Columbia 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 and is internationally recognized as an innovative world leader in combating HIV/AIDS and related diseases. BC-CfE is based at St. Paul’s Hospital, Providence Health Care, a teaching hospital of the University of British Columbia. The BC-CfE works in close collaboration with key provincial stakeholders, including health authorities, health care providers, academics from other institutions, and the community to decrease the health burden of HIV and AIDS. By developing, monitoring and disseminating comprehensive research and treatment programs for HIV and related illnesses, the BC-CfE helps improve the health of British Columbians living with HIV.

About Simon Fraser University (SFU):

As Canada’s engaged university, SFU is defined by its dynamic integration of innovative education, cutting-edge research and far-reaching community engagement. SFU was founded almost 50 years ago with a mission to be a different kind of university—to bring an interdisciplinary approach to learning, embrace bold initiatives, and engage with communities near and far. Today, SFU is a leader amongst Canada’s comprehensive research universities and is ranked one of the top universities in the world under 50 years of age. With campuses in British Columbia’s three largest cities—Vancouver, Surrey and Burnaby—SFU has eight faculties, delivers almost 150 programs to over 30,000 students, and boasts more than 130,000 alumni in 130 countries around the world.

About the Canadian HIV Observational Cohort (CANOC) Collaborative Research Centre:

The Canadian HIV Observational Cohort (CANOC) Collaborative Research Centre focuses on HIV health services and epidemiologic cohort research. This national collaboration conducts policy-relevant studies in HIV therapeutics, population and public health. The CANOC Centre brings together a diverse team to capitalize on the unique and robust CANOC database, maximizing the quality and breadth of the health services and policy research generated. The Centre is funded by the Canadian Institutes of Health Research (CIHR) and the CIHR Canadian HIV Trials Network (CTN242).

CANOC’s newly-launched website at www.canoc.ca contains up-to-date information on all current Centre principal investigators, co-investigators, staff, and community collaborators, as well as information on CANOC publications and conference presentations. The call for scholars and community investigators, which will be launched in the coming months, will also be posted on the website.

About the Canadian Institutes of Health Research (CIHR):

The Canadian Institutes of Health Research (CIHR) is the Government of Canada’s health research investment agency. CIHR’s mission is to create new scientific knowledge and to enable its translation into improved health, more effective health services and products, and a strengthened health care system for Canadians. Composed of 13 Institutes, CIHR provides leadership and support to more than 13,200 health researchers and trainees across Canada. www.cihr-irsc.gc.ca

Media inquiries:

British Columbia media inquiries:

SFU Spokesperson:

Dr. John O’Neil
Professor, Faculty of Health Sciences
Phone: 778-782-5361
Office: BLU 11328
Email: joneil@sfu.ca

SFU Communications contact:

Carol Thorbes
Information Officer
Simon Fraser University (SFU)
Public Affairs and Media Relations
Room 2200 Strand Hall
Phone: 778-782-3035
Email: cthorbes@sfu.ca

CfE Communications contact:

Marina Irick
CANOC Research Coordinator
Epidemiology & Population Health
BC Centre for Excellence in HIV/AIDS
608-1081 Burrard Street, Vancouver BC, V6Z 1Y6
Phone: 778-835-8771
Email: mirick@cfenet.ubc.ca

Ontario Media inquiries:

OTTAWA Communications contact:

Dr. Curtis Cooper, MD, FRCPC
Associate Professor of Medicine- University of Ottawa
The Ottawa Hospital- Division of Infectious Diseases
Email: ccooper@toh.on.ca

Ontario HIV Treatment Network Communications contact:

Dr. Ann Burchell
The Ontario HIV Treatment Network
1300 Yonge Street, Suite 600, Toronto, ON, M4T 1X3
Phone: 416-642-6486 extension 2210
Email: aburchell@ohtn.on.ca or ann.burchell@utoronto.ca

University Health Network/Toronto General Hospital Communications contact:

Alexandra Radkewcyz
Senior Public Affairs Advisor
Toronto General Hospital, Munk Building Room LC-409
200 Elizabeth Street, Toronto, ON, M5G 2C4
Phone: 416-340-4800 x 3895
Email: alexandra.radkewycz@uhn.ca

Maple Leaf Medical Clinic Communications contact:

Dr. Mona Loutfy, Research Director
Phone: 416-725-9566
Email: mona.loutfy@wchospital.ca

Quebec Media inquiries:

McGill University Health Centre Communications contact:

Dr. Marina Klein
Research Director
McGill University Health Centre, Chronic Viral Illness Service, Montreal Chest Institute
3650 Saint Urbain Street, Montreal, Quebec, H2X 2P4
Phone: 514-843-2090
Email: marina.klein@ mcgill.ca

Montreal General Hospital Communications contact:

Dr. Chris Tsoukas
McGill University Health Centre
1650 Cedar Ave, Room A5-140, Montreal, QC
Tel: 514-934-8035
Fax: 514-937-1424
Email: chris.tsoukas@muhc.mcgill.ca

L’Actuel Medical Communications contact:

Dr. Réjean Thomas
President-Director general, Founder
Clinique médicale L’Actuel
1001 boul. de Maisonneuve Est, Suite 1130, Montreal, QC, H2L 4P9
Phone: 514-524-3642 ext. 264
Email: Rejean.Thomas@lactuel.ca

– Or –

Nimâ Machouf
Epidemiologist
Clinique medicale L’Actuel
Phone: 514-524-3642 ext. 287
Email: Nima.machouf@lactuel.ca

Saskatchewan Media inquiries:

Southern Saskatchewan HIV Cohort Communications contact:

Dr. Alexander Wong
4E – Regina General Hospital
1440 14th Avenue, Regina, Saskatchewan, S4P 0W5
Tel: 306-766-3915
Fax: 306-766-3995

Saskatoon (SHARE) Communications contact:

Dr. Stephen Sanche
Division of Infectious Diseases, Department of Medicine, University of Saskatchewan
Royal University Hospital
103 Hospital Drive, Saskatoon, SK, S7N 0W8
Phone: 306-655-6658
Email: Stephen.sanche@usask.ca

– Or –

Dr. Stryker Calvez
Project Coordinator/Researcher
Saskatchewan HIV/AIDS Research Endeavour
1120 20th Street, Saskatoon, SK, S7M 0Y8
Email: Stryker.calvez@usask.ca

Switching from first-line ART with suppressed viral load linked to treatment failure

People who switch away from their initial antiretroviral therapy (ART) regimen when their viral load is undetectable may have a higher likelihood of subsequent virological failure, researchers reported at the 20th International AIDS Conference last week in Melbourne. However, the association varied across groups and the researchers suggested their findings may reflect issues such as adherence or treatment changes due to pregnancy.

Experts recommend starting HIV treatment with a maximally potent combination antiretroviral regimen, especially for people with high viral load. But even in the modern ART era many people wish to switch regimens for the sake of better tolerability or simplicity. Prior studies indicate that about 40% of patients modify their first regimen.

Marina Klein of McGill University in Montreal and colleagues evaluated why people switch first-line regimens for reasons other than inadequate viral suppression – for example, to reduce side-effects or improve convenience – and the link between switching and subsequent virologic failure. Suppressed viral load was defined as two HIV RNA measurements below 50 copies/ml at least one month apart; virological failure was defined as viral load above 1000 copies/ml.

This analysis looked at 2807 previously untreated people with HIV in the multi-site Canadian CANOC cohort who started combination ART between 2005 and 2012. Most (87%) were men and the median age was 42 years. The median baseline CD4 T-cell count was 260 cells/mm3, 12% had a history of injecting drug use and 15% were coinfected with hepatitis C virus (HCV).

Liz Highleyman
nam aidsmap
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Rx Switching Tied to HIV Viral Breakthrough

MELBOURNE, Australia — Patients on stable antiretroviral regimens who switch to another therapy have a significantly increased risk of experiencing HIV virologic failure on the new regimen compared with nonswitchers, a retrospective database analysis suggested.

The risk of virologic failure was increased 35% (P<0.001) when those patients who changed therapies were compared with patients who never switched, said Marina Klein, MD, of McGill University in Montreal.

Study Design

Klein and colleagues accessed the CANOC database, which records data from Canada’s largest pan-provincial HIV treatment cohort study. The researchers evaluated adults with a first antiretroviral therapy date from Jan. 1, 2000, onward, and reviewed their charts from Jan. 1, 2005, to June 30, 2012.

Of the 2,807 patients included in the study, 1,804 were never switched and 391 patients switched regimens once; 612 switched more than once. The time to the first switch was about 10 months.

Ed Susma
MedPage Today
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Disentangling IDU and HCV impacts on HIV outcomes in Canadians

Canadians coinfected with HIV and hepatitis C virus (HCV) had a worse response to antiretroviral therapy (ART) and a higher death rate if they had an injection drug use (IDU) history. The findings could clarify understanding of how HCV affects HIV infection.

CANOC Collaboration investigators observed that worse clinical outcomes seen in HIV/HCV-coinfected people may be partly attributable to socioeconomic and medical factors associated with injection drug use, which is the prime route of HCV transmission in people with HIV.

To assess the impact of injection drug use on HIV outcomes, the CANOC team studied coinfected people starting ART after 1 January 2000. The analysis included only people known to have—or not to have—an IDU history. The researchers used Cox proportional hazards regression to evaluate time from ART initiation to virologic suppression (two consecutive viral loads below 250 copies/mL) and gaining at least 100 CD4 cells/μL. To evaluate time to death, they used a competing risk analysis to account for loss to follow-up (dropping out of care).

International AIDS Society
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Research Profile – Going Non-Viral: Achieving HIV Suppression

A Canadian living with the human immunodeficiency virus (HIV) is most likely to achieve “viral suppression” if they are male, reside in Ontario and have no history of injecting drugs, according to findings drawn from the largest databank of national HIV patient information ever collected.

Achieving viral suppression – reaching and maintaining the point at which the virus is under control – is crucial for two reasons: it prevents an HIV-positive person from progressing to AIDS, and it helps stop the spread of HIV.

“By suppressing someone’s viral load, they are much less likely to become ill with HIV,” says Dr. Curtis Cooper, a University of Ottawa researcher and a regional director of the Canadian Observational Cohort (CANOC). “On a public health basis, it protects the population because the risk of transmitting HIV with a fully suppressed viral load is minuscule. I would not say you cannot transmit it, but it reduces the risk of transmission multifold.”

CANOC has collected data from over 8,000 patients in British Columbia, Ontario and Quebec who are receiving highly active antiretroviral therapy (HAART), the standard of care for HIV infection. In a study published last year in the British journal HIV Medicine, CANOC’s researchers reported that the median time for a Canadian HIV patient to reach viral suppression is 4.5 months.

Canadian Institutes of Health Research
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B.C. women with HIV at higher risk for drug failure, study discovers

B.C. women with HIV are more than twice as likely as women in Quebec or Ontario to experience “viral load rebound” -which means their medication stops killing the virus, and their disease rebounds to a higher level than before they went on the drugs.

In B.C., 33.6 per cent of women in a national study experienced this condition, versus 13.3 per cent in Ontario and 13.5 per cent in Quebec.

Louise Binder, chairwoman of the Canadian Treatment Action Council, was diagnosed with HIV 17 years ago after getting infected by her husband. She experienced viral load rebound seven years ago.

Binder said the condition can occur when women are not consistent with their medication or the medication they are taking stops being effective. For her, it was the latter.

“I had been taking the same medication a very long time,” said the 61-year-old from Toronto. “The virus changes over time. It does that intentionally to get around your drugs and that is what happened to me. In a sense, the virus outsmarts the drugs.”

Binder said she was lucky because after changing her medication, the virus levels in her system decreased again.

Others aren’t so fortunate.

Dr. Robert Hogg, a researcher at the BC Centre for Excellence in HIV/AIDS and one of the principal researchers on the study, said part of the reason for the higher numbers in B.C. could be that the study encompassed all of B.C. while focusing on Toronto and Montreal back east.

Kim Pemberton
The Vancouver Sun
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