New HIV screening opportunities identified, according to BC-CfE study

published on March 21, 2019

1 in 7 individuals could have been diagnosed with HIV earlier

(Vancouver, BC | March 21, 2019) A study from the BC Centre for Excellence in HIV/AIDS (BC-CfE) uncovered new opportunities in the health care system to diagnose individuals living with HIV. In 2017, nearly a quarter of those diagnosed with HIV in BC had a CD4 count that was low, a major indicator of a weakened immune system and advanced HIV disease.

HIV testing rates have steadily increased in the province since 2014, with more than 87,900 British Columbians accessing an HIV test in the last quarter of 2018. However, data analyzed by the BC-CfE showed 1 in 7 individuals living with HIV in BC could have been diagnosed earlier—if health care providers had recognized certain key clinical conditions as triggers for HIV screening.

“It’s critical that we take every chance to implement the tools at our disposal to curb HIV,” said Dr. Julio Montaner, BC-CfE Executive Director and Physician-in-Chief. “More than ever, health care providers, policymakers and the public must be on high alert for complacency when it comes to HIV. We must continue to build on the progress we have made towards meeting our target to end AIDS in BC.”

According to the BC-CfE study, published today in the leading scientific journal PLOS-ONE, individuals aged 40 years or older, heterosexuals, people living in remote areas and people who had ever injected drugs were more likely to have had a missed opportunity for an earlier HIV diagnosis.

“HIV can affect people regardless of their age or sexual orientation. Anybody can ask their health care provider for an HIV test,” said Dr. Bonnie Henry, BC Provincial Health Officer and an author on the study. “When you get tested for HIV, you are taking care of your health and helping to protect the health of others.”

“There is still more that could be done to ensure individuals are accessing regular HIV tests,” said Dr. Viviane Lima, BC-CfE Research Scientist and senior author on the study. “Increased opportunities for HIV diagnosis—and earlier diagnosis—can be identified by supplementing current testing guidelines with specific clinical indicators. Essentially, a better understanding of non-AIDS clinical conditions associated with HIV can help optimize HIV screening.”

Researchers defined a missed HIV testing opportunity as an encounter with a health care provider due to a condition or clinical symptoms possibly associated with HIV. This included recurrent pneumonia, shingles among individuals younger than 50 years old and anemia.

A late diagnosis of HIV can affect individuals by increasing their risk of hospitalization, progression to AIDS and premature mortality. Missed opportunities for earlier HIV diagnoses can also increase the risk of transmission of the virus to others and can put increased demand on the health care system.

BC HIV testing guidelines, available since 2014, recommend health care providers offer individuals an HIV test every five years. Individuals considered at high-risk of HIV are recommended to have an HIV test more frequently, at least once per year.

Background
A key component of curbing new HIV infections is earlier access to HIV testing. Through the implementation of the BC-CfE pioneered Treatment as Prevention (TasP) strategy in BC, individuals are generally being reached with earlier access to HIV testing and universal access to sustained HIV treatment. According to research from the BC-CfE and others, the made-in-BC TasP strategy is costs-savings by averting health care costs and productivity loss due to reduced new cases of HIV. TasP forms the foundation of the UNAIDS 90-90-90 Target to end AIDS globally by 2030. To reach this goal, by 2020, 90% of individuals living with HIV must be diagnosed, 90% of the individuals diagnosed must be on HIV treatment, and 90% of those on treatment must be virally suppressed.

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—nationally and internationally recognized as an innovative world leader in combating HIV/AIDS and related diseases. The made-in-BC Treatment as Prevention strategy (TasP), pioneered by the BC-CfE and supported by UNAIDS since 2011, inspired the ambitious global target for HIV treatment—known as the 90-90-90 Target—to end AIDS as a pandemic by 2030. The BC-CfE is applying TasP to therapeutic areas beyond HIV/AIDS, including viral hepatitis and substance use disorders, to promote Targeted Disease Elimination as a means to contribute to health care sustainability. The BC-CfE works in close collaboration with key stakeholders, including government, health authorities, health care providers, academics and the community to decrease the health burden of HIV/AIDS, hepatitis C and substance use disorders across Canada and around the world.

Contact:
Caroline Dobuzinskis, BC-CfE
Cell: 604-366-6540
Email: cdobuzin@cfenet.ubc.ca

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Treatment as Prevention®

Julio Montaner

BC Centre for Excellence in HIV/AIDS

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New HIV screening opportunities identified, according to BC-CfE study

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