Slide 1 of 42 IAS–USA AU EDITED FINAL: 03-18-13 Julio Montaner, MD Professor of Medicine, and...

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IAS–USAAU EDITED FINAL: 03-18-13

Julio Montaner, MDProfessor of Medicine, and Head, Div. of AIDS, University of British Columbia

Director, BC-Centre for Excellence in HIV/AIDS at Providence Health CarePast President, International AIDS Society (2008-2010)

Treatment as Prevention:The Key to an AIDS-Free Generation

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January 2004

Summer of 1996

Year

Summer of 2000

Phase I Phase II Phase III

Montaner et al, Lancet, 2010

Increasing HAART Coverage within Evolving Guidelines in BC

N = 7492 by the end of 2011

Julio Montaner

Describe number of HAART starts and stratified by PI vs NNRTI

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Pre-HAART CD4 counts in BCby year, 2003-2012

Lima et al, in preparation, 2013

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Adherence to HAART in BCby year, 1996-2012


of 44HIV Drug Resistance in BC

by year, 1996-2012


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BC: All Cause Mortality (#)

0

50

100

150

200

250

300

350

400

1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Years

Freq

uenc

y

> 90% Decrease in All Cause Mortality among HIV Infected Individuals in BC since 1996

Montaner et al, TasP Workshop, April 2012

of 44AIDS New Cases for BC by year, 1996-2011


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BC: HIV Prevalence and TB Incidence

James Johnston, WIP, May 2013

of 44HAART Use & New HIV Diagnoses for BC by year, 1996-2012


HIV Incidence

Active on HAART

New HIV Diagnoses (All)

New HIV Diagnoses (Ever IDU)

of 44Annual rates (per 100,000 population) for new cases of genital chlamydia, genital gonorrhea, infectious syphilis and

hepatitis C, 1996-2012


Hepatitis C Syphilis

GonorrheaChlamydia

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Programmatic Compliance Score Assesses the impact of non-

compliance with HIV treatment guidelines on all-cause mortality

PCS components include: Baseline CD4 > 200/mm3 Three CD4 in 1st year Three VL in 1st year Baseline resistance Recommended HAART Undetectable pVL at 9 months

Failure to meet a given component add one to the score

PCS predicts mortality

Lima et al. PLoS ONE 7(11): e47859. 2012

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PCS in BC 2000 to 2011


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R Lester, M Morshed, and M Gilbert, BCMJ, May 4th 2013

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red = drug resistance at

baselinenode size = date

of baseline sample

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HIV Diagnoses by Region and YearPublic Health Agency of Canada

Link4th Intl HIV TREATMANT AS PREVENTION Workshop

April 1st to 4th 2014 - Vancouver, BC, Canada.

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In Collaboration with PHC, VCHA, NHA, PHSA, Community, and MoH

Slide 1 of 42 IAS–USA AU EDITED FINAL: 03-18-13 Julio Montaner, MD Professor of Medicine, and...

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