Increased coverage with HIV therapy could reduce transmission and generate health care savings: study

published on July 2, 2008

(Vancouver) – A new study by the BC Centre for Excellence in HIV/AIDS (BC-CfE) reveals the dramatic impact that increased coverage with HIV therapy could have in reducing HIV transmissions in B.C. while saving money for the province’s health care system.

The study, published in the Journal of Infectious Diseases, used a novel mathematical model to assess the potential effects of increased treatment coverage with Highly Active Anti-Retroviral Therapy (HAART) among HIV-positive individuals in medical need of treatment in British Columbia. The model is reflective of the next 25 years.

"We’ve known for some time that the expansion of coverage with HAART could help to reduce the number of new HIV infections. However, we were amazed at the actual number of new infections that can be potentially adverted by expanding access to treatment,” says BC-CfE director Dr. Julio Montaner.

Despite universal access to health services and antiretroviral therapy in B.C., over 50 per cent of patients fail to access treatment in a timely fashion.

According to the study, an increase in HAART coverage from a level of 50 per cent among those in medical need, to 75, 90 and 100 per cent could lead to a decrease in the annual number of individuals testing newly HIV positive for the disease by over 30, 50 and 60 per cent respectively.

The study consistently predicted that enrolling at least 75 per cent of individuals clinically eligible for treatment would be associated with a substantial decrease in new HIV infections.

In terms of cost, the BC-CfE’s study shows that if HAART expansion was done immediately, it would generate total and per capita lifetime treatment cost savings starting at $95 million and $368 thousand, respectively.

"Even though immediate HAART uptake has initial cost implications in the short-term, our research shows that more new people will test positive for HIV the longer it takes to expand coverage,” Montaner explains.

The study results provide powerful additional motivation to accelerate the roll out of HAART programs,” Montaner adds. “We need to aggressively target those in medical need, both for their own individual benefit and as a means of decreasing new HIV infections in the general population.”

HAART has led to a dramatic decrease in morbidity and mortality among individuals infected with HIV, and international guidelines widely recommend that HAART be used before overt immune deficiency is apparent.

BC Centre for Excellence in HIV/AIDS

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Increased coverage with HIV therapy could reduce transmission and generate health care savings: study

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