B.C To Seek and Treat Most Vulnerable HIV Patients

Vancouver, February 4, 2010 — A unique pilot program will get underway shortly in Vancouver’s Downtown Eastside and Prince George to seek and treat vulnerable populations who are either undiagnosed or untreated for HIV.
The four-year, $48-million pilot called Seek and Treat is the first of its kind in Canada and believed to be the first internationally. It will expand access to HIV/AIDS medications among hard-to-reach populations, including sex trade workers, injection drug users and men who have sex with men. By reaching and engaging more British Columbians living with HIV/AIDS in Highly Active Anti-retroviral Therapy (HAART), not only will better care be provided but the treatment will also significantly reduce or eliminate the virus’ ability to spread.

“Seek and Treat promises to decrease HIV and AIDS-related suffering and further prevent the spread of HIV,” said Health Services Minister Kevin Falcon. “British Columbia continues to be a recognized global leader in the fight against HIV/AIDS with this groundbreaking approach thanks to the BC Centre for Excellence in HIV/AIDS at St. Paul’s Hospital under the leadership of Dr. Julio Montaner.”

Northern Health, Vancouver Coastal Health and Providence Health Care will lead the regional implementation of the pilot with support from the Provincial Health Services Authority, including the BC Centre for Disease Control, under the leadership of the BC Centre for Excellence in HIV/AIDS.

For British Columbians who know they have HIV/AIDS and are connected to the health-care system, accessing HAART is relatively straightforward and can have extremely positive outcomes. However, there is a large segment of the at-risk population who are not connected to the health system, and Seek and Treat aims to go out, diagnose, support and provide treatment to those who are medically eligible where possible.

“B.C. is passionate about making prevention the cornerstone of this new pilot program with the goal of having a reduction in the number of people who become infected with HIV,” said Ida Chong, Minister of Healthy Living and Sport.

The pilot emphasizes providing focused, enhanced care and support, such as HAART, which was pioneered by Dr. Montaner at the BC Centre for Excellence in HIV/AIDS in the early 1990s, and introduced as the new standard of care by the Centre at the 1996 International AIDS Conference in Vancouver.

HAART is available free of charge to all HIV- infected B.C. residents through the BC Centre for Excellence. Since 2004, the number of people using HAART has doubled to more than 5,000.

“Seek and Treat expands the reach of HIV treatment and will result in decreased progression to AIDS among HIV- infected individuals and fewer new HIV infections among those at risk,” said Dr. Julio Montaner, director of the BC Centre for Excellence in HIV/AIDS and the original developer of this innovative concept. “Through Premier Campbell’s commitment to HIV treatment, care and research, we will reduce AIDS-related deaths and HIV infections in B.C., and we will show the world how to do it.”

Seek and Treat will also open up the opportunity to respond to regional increases in AIDS infection and mortality. This will target HIV care in the Downtown Eastside, the North and among Aboriginal populations as recommended in the provincial health officer’s report, Pathways to Health and Healing. Engagement in the pilot will be strictly voluntary, using standard practices including participants’ informed consent.

Merck has committed $1.5 million over three years to the BC Centre for Excellence in HIV/AIDS to help evaluate the pilot program.

“The BC-CfE is a pioneer in HIV/AIDS research, and continues to be a leader in the global effort to provide innovative therapies and healthcare strategies to combat this epidemic,” said Gregg Szabo, vice-president, Specialty Products at Merck. “We are proud to support the BC-CfE and the B.C. government in their efforts to expand care for British Columbians living with HIV/AIDS and prevent further HIV infections in the province and throughout Canada.”

Operating and drug cost for the pilot are provided by the Province. The operating cost for the pilot is $1.66 million in 2009-10, $4.9 million in 2010-11, $16.5 million in 2011-12 and $16.5 million in 2012/13. Drug costs are $2 million in 2010-11, $3.4 million in 2011-12 and $3.4 million 2012-13.

For patients, HAART treatment prevents virus replication, slows disease progression, extends life expectancy and significantly reduces the number of new HIV-related diseases and AIDS-related deaths. The BC Centre for Excellence in HIV/AIDS has provided groundbreaking new evidence that treatment of people living with HIV in a given jurisdiction can also dramatically decrease the transmission rates of HIV.

It is estimated that more than 12,000 people in B.C. are living with HIV, and approximately 27 per cent of these individuals remain undiagnosed.

Mathematical modelling suggests that this pilot project in these two regions could avert as many as 173 HIV infections in the first five years, which in turn, represents about $65 million in avoided lifetime HIV treatment costs alone.