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Researcher calls for immediate treatment once people diagnosed with HIV

BY INGRID BROWN Associate editor — special assignment browni@jamaicaobserver.com

Friday, November 30, 2012    

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VANCOUVER, Canada — Dr Julio Montaner and his team of researchers at the British Columbia Centre for Excellence in HIV/AIDS here want governments around the world to provide highly active antiretroviral treatment (HAART) to HIV-infected persons immediately following their diagnosis, if they are to stem the rate of new infections.

Dr Montaner pointed to research which showed that infected persons on antiretrovirals are less likely to transmit the disease to others.

"HIV incidence decreased by five per cent for each one per cent increase in HAART coverage," he told a Jamaican delegation of journalists and policymakers who are here to observe best practices in Vancouver, Canda under an exchange organised by Panos Caribbean .

The exception of placing newly diagnosed patients on medication, Dr Montaner said, should only be made with persons whose CD4 count is more than 500 and not the 350 specified by the World Health Organisation (WHO) and those with undetectable viral loads. Persons who fall in this category are one in every 1,000 infected persons

Under current WHO guidelines for treatment, HIV infected persons should be placed on antiretrovirals when their CD4 count has dropped below 350.

HAART, Dr Montaner explained, stops HIV replication after which the HIV load falls to undetectable levels in plasma as well as in sexual fluids, and this results in sharp reduction in HIV transmission.

The United Nations, he added, is not yet ready to insist that every country should begin immediate treatment as governments will complain of not being able to afford the medication, but said it does not make economic sense as what is spent on medication would go towards treating the rise in new infections in the long term.

He added: "The time people wait to have treatment is what is perpetuating the disease, even if treating earlier was of no benefit to persons it is saving other persons from infection."

UNAIDS Caribbean data in 2010 revealed that only 48 per cent of those who need the life saving drugs in the Caribbean have access to it, while less than half of infected Jamaicans who need to be on treatment are given the drugs.

Vancouver is one of the few places in the world which has seen a decrease in new HIV infections, which Dr Montaner attributed to the fact that the province makes HIV treatment, inclusive of medication and lab work, free to all infected persons. Government, added Dr Montaner, has also facilitated access to treatment through the provision of housing and food to infected persons.

He said a research has shown that a 20 year-old who has been diagnosed with HIV can expect to live another 53 years, something which was unheard of up to a decade ago.

In Canada, it cost $15,000 per year for antiretroviral for an individual as the country's laws do not allow for the use of generic drugs. As such Dr Montaner and his team are pushing for the treatment to become free in all the other provinces in Canada.

In a developing country like Africa, Dr Montaner said it would cost between US$150 to $300 for the yearly supply of medication as they are allowed to use generic drugs. Additionally, the researcher said there is a need to normalise HIV testing as persons will be better able to protect themselves when they are aware of their status.

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