When a person is able to consistently stay on a course of HIV treatment that works effectively, their quality of life improves and their viral load becomes undetectable, meaning they cannot transmit the HIV virus to others. These concepts form the Treatment as Prevention¨ (TasP¨) strategy, pioneered at the BC Centre for Excellence in HIV/AIDS (BC-CfE) in Vancouver. TasP¨ has the goal of reaching people living with HIV through early testing and treatment in order to improve their overall health while reducing transmission of the disease. It forms the basis of the United Nations’ Sustainable Development Goal and the UNAIDS 90-90-90 target to end AIDS by 2030. To achieve the 90-90-90 target globally means diagnosing 90% of people living with HIV, treating 90% of those diagnosed, and achieving viral suppression of HIV in 90% of those treated.
Personalized medicine is an important piece of the TasP¨ strategy. On a daily basis, the BC-CfE conducts genome analysis of HIV virus samples from across the province, across Canada (except Quebec) and many places around the world. In British Columbia, HIV genomic analysis forms part of the standard of care when an individual has a detectable HIV viral load. The process, called resistance testing, allows for the identification of variants of the virus that are resistant to current HIV therapies. Those instances, due to virus mutations, are communicated to physicians to inform treatment decisions for the patient.