Thanks to effective anti-HIV treatment, HIV has evolved into a chronic illness. However, people living with HIV often today also live with other physical and mental health conditions, which can be difficult to cope with, especially for those also coping with difficult socio-economic circumstances.
To provide quality care to people living with HIV and other long-term medical and social conditions, health-care providers not only need to ensure that people living with HIV are engaged in quality health care, but we also need to enhance the capacity of Canadian HIV clinics to integrate and coordinate additional resources. By integrating and coordinating resources, we help address the needs of a whole person —needs that often cut across the various disciplines, specialties, sectors and systems that we have traditionally organized care around.
The good news is that through several interconnected research studies, our research team led out of the Bruyère Research Institute in Ottawa has shown that the complex health and social care needs of people living with HIV can be met –and, in fact, are being met –by various care models, settings and teams working in HIV clinics across Canada.
The last seven years have seen a whirlwind of hepatitis C virus (HCV) drug development. Each new treatment is generally more potent than the last. The latest treatments approved for HCV in Canada this week include Maviret (made by AbbVie) and Vosevi (made by Gilead). Clinical trials of these treatments, which people take in pill form, resulted in high rates of cure (usually greater than 95 per cent) with few serious side effects. Although it will be six months or more before these drugs ascend to provincial, territorial and other formularies, their approval signals that the end of drug development for HCV is in sight.
Every year on July 28, we mark World Hepatitis Day with an event to educate, gather together, and also remember those we have lost from the hepatitis C community. This year, we should have much to celebrate: in early 2017, medications that had previously been unavailable were finally added to some formularies, including Ontario’s. This means that people with certain types of hepatitis C who have been waiting years to access safe, effective medication will finally be able to start treatment and be cured. For many, being cured means avoiding potentially fatal outcomes like liver failure and liver cancer. It also means shedding the burden of carrying a highly stigmatized illness that is often met with ignorance, ostracism and discrimination.
The hepatitis C virus (HCV) is a major public health problem. Worldwide, about 70 million people are living with hepatitis C virus infection, with a higher prevalence in developing countries. In Canada, 210,753 to 461,517 people are infected with HCV, and an estimated 20 to 40 per cent of infections remain undiagnosed. Those born during the period of 1945 until 1965 have the highest rates of infection and, having acquired the virus decades ago, are now increasingly being diagnosed with serious liver-related illnesses, including liver failure and liver cancer and non-liver related illnesses such as cardiovascular disease, diabetes and kidney disease.
People living with HIV in Canada have been charged with some of the most serious offences in the Criminal Code, even in cases of consensual sex where there was negligible or no risk of HIV transmission, no actual transmission and no intent to transmit.
The Undetectable=Untransmittable (“U=U”) campaign is based on scientific research, including the ground-breaking PARTNER study, establishing that when a person living with HIV on treatment maintains an undetectable viral load for at least six months, the risk of transmitting the virus through sex is effectively non-existent. As advocates for persons living with HIV await action from federal, provincial and territorial governments to address the overly-broad criminalization of HIV non-disclosure, how might the U=U campaign and the results of the PARTNER study impact ongoing prosecutions under the current state of the law?
The CATIE Blog hosts the views and opinions of people and organizations working and volunteering in Canada’s response to HIV and hepatitis C.