1 / 10

THAX0103

THAX0103.

chelsey
Download Presentation

THAX0103

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. THAX0103 Enhanced adherence to HAART is associated with further decrease in HIV drug resistance within a population-basedHAART expansion initiative in British Columbia (BC)Viviane D. Lima, P. Richard Harrigan, Benita Yip, Robert S. Hogg, Julio S.G. MontanerBritish Columbia Centre for Excellence in HIV/AIDSvlima@cfenet.ubc.ca

  2. Background • Recently, there have been concerns raised regarding the potential for rising HIV drug resistance as a result of the widespread use of HAART. While these data were based on the San Francisco experience, the model was felt to be relevant to other countries (Smith et al, Science, 2010). • Here, we characterize the population-wide trends in HIV drug resistance, before and after a HAART expansion initiative started in BC in 2004.

  3. Methods • Longitudinal data on adherence to HAART and genotypic resistance were obtained from all patients on HAART from July 1, 1996 to December 31, 2008. • Adherence was based on prescription refills. • Samples were assigned to resistance categories based on a list of important resistant mutations in the RT and PR genes. • HAART, medical care and laboratory monitoring are free of cost to all eligible individuals in BC.

  4. Data • We prospectively followed 7736 patients; 70% (N=5422) of them had a total of 24,652 resistance tests during follow-up. • Individuals on HAART have increased from 837 in 1996 to 5,123 in 2008 (547% increase; p<0.0001). • Approximately, 30% of individuals have ever injected drugs in each of the follow-up years.

  5. Adherence and Resistance (Median)

  6. Adherence Distribution

  7. Resistance Rate per 10,000 person-months Gill et al, CID 2010

  8. Virologic Suppression Montaner et al. Lancet 2010 (in press)

  9. Conclusions • Our results showed a decreasing trend in HIV drug resistance over time, within a population-based HAART expansion initiative in BC, associated with increasing adherence and consequently increasing rates of viral suppression. • Based on these results, it is premature to conclude that HAART expansion programs will be necessarily undermined by the emergence of high rates of HIV drug resistance.

  10. Acknowledgements • BCCfE data entry and administrative staff • BCCfE participants • Funding • Ministry of Health Services and Ministry of Healthy living and Sport, Province of British Columbia. • Canadian Institutes of Health Research and Michael Smith Foundation for Health Research through Fellowship Awards to Dr. Lima. • Dr. Montaner is a recipient of an Avant-Garde Award from the National Institutes of Drug Abuse, NIH.

More Related