Original posted on CATIE.
Top 10 HIV and Hep C Research News from 2013
What were the most notable HIV and hepatitis C research stories from 2013? We’ve listed the top 10 stories from CATIE News below.
From national guidelines for HIV testing to best practice recommendations for harm reduction programs, 2013 was a good year for evidence-based approaches to HIV and hepatitis C.
The Public Health Agency of Canada’s new HIV testing guide included recommendations to promote HIV testing during routine medical care. Quebec’s Ministry of Health and Social Services released an interim opinion on pre-exposure prophylaxis. A cross-Canada team of harm reduction experts produced a set of best practice recommendations. And the Canadian HIV Trials Network published treatment guidelines for people co-infected with HIV and hepatitis C.
These new guidelines are welcome advances in evidence-based approaches to HIV and hepatitis C prevention and treatment.
Media attention in 2013 focused on reports that a baby had been “functionally cured” of HIV and a claim that Danish researchers were on the brink of a cure for HIV – both stories that had been widely misreported.
All currently-available treatments for hepatitis C contain interferon, a protein that attacks the reproduction of the hepatitis C virus (HCV). Unfortunately, a large fraction of people with HCV cannot tolerate interferon, making the side effects of treatments intolerable for many.
Promising research took place this year into treatments without interferon, including studies on Sofosbuvir, Simeprevir, and a completely oral interferon-free regimen. Over the next few years, the course of treatment for hepatitis C should also become shorter, ranging from 12 to 24 weeks.
Research studies have demonstrated that effective antiretroviral therapy can greatly reduce viral load in a person with HIV and greatly reduce their risk of passing on the virus. With this knowledge, the B.C. Centre for Excellence in HIV/AIDS has advocated a “treatment as prevention” approach: expanding access to HIV treatment to also reduce the spread of the virus.
This year, the theory was put into action in many jurisdictions around the world –with some successes and some lessons learned – and based on the results of British Columbia’s own three-year pilot project in Vancouver and Prince George (Seek and Treat for the Optimal Prevention of HIV, or STOP), the program was expanded across the province.
The application of “treatment as prevention” to hepatitis C is also being considered. However, unless treatment as prevention for hepatitis C is well-resourced, it will face many challenges.
With an estimated 1 out of every 33 baby boomers in Canada living with hepatitis C, Canadian liver specialists recommended the development of a national strategy to screen baby boomers for hepatitis C. A screening program would be cost-effective in Canada, they said, because finding and treating people with hepatitis C would prevent costly medical problems like end stage liver disease and liver transplants, as well as reducing the mortality caused by Hep C.
Pre-exposure prophylaxis (PrEP) – when an HIV-negative person takes antiretroviral drugs prior to a potential exposure – has already shown promising results in reducing the risk of infection from a sexual exposure. But new research in 2013 demonstrated that PrEP is also effective at reducing the risk of HIV among people who inject drugs.
Liver cancer is the second fastest-growing cancer among Canadians, tripling among men and doubling among women since 1970, according toCanadian Cancer Statistics 2013. The main risk factors for liver cancer are chronic hepatitis B and C infections.
Studies have long suggested a link between HIV infection and an increased risk of heart disease. However, these risks could have been attributed to other factors that are often present in people with HIV, such as smoking, mental health issues, or co-infection with other viruses.
In 2013, U.S. researchers conducted a study to isolate these other factors, and concluded that HIV increases the risk of heart attack by 50 per cent, even among people who do not smoke tobacco, use substances or have other health conditions.
Over the past decade (from 2000 to 2010), syphilis rates in Canada have skyrocketed – a 910% increase. The higher rates of syphilis may be furthering the spread of HIV, and the epidemic is disproportionately affecting people living with HIV. Frontline service providers across the country responded to these epidemics with awareness-raising and testing campaigns.
Sixty-one per cent of Canadians said they had low or medium knowledge of HIV/AIDS according to a survey conducted for the Public Health Agency of Canada. Only 39 per cent felt they had high knowledge of HIV/AIDS, a decrease from 46 per cent in 2003. The survey found that knowledge of hepatitis C is even lower, with 86 per cent feeling that they are not knowledgeable or moderately knowledgeable about the virus.