Following the results of a new study from the BC Centre for Disease Control (BCCDC), British Columbia will be the first in Canada to use a new, more accurate HIV detection test. The study found nucleic acid amplification testing (NAAT) greatly improved the diagnosis of early or acute HIV infection.
The study, published in the AIDS Journal, estimates between 25 and 75 new HIV infections were avoided due to the NAAT testing done since April 2009 at six clinics accessed by gay and bisexual men in Vancouver.
“Our government is committed to reducing the spread of HIV by ensuring those living with HIV/AIDS have access to the best care and treatment, and it is very exciting that this groundbreaking research is going on right here in B.C.” says BC Minister of Health, Terry Lake. “As part of our vision of an AIDS-free generation, we’ve committed $19.9 million in annual funding to health authorities to support the expansion of STOP HIV/AIDS throughout B.C., and we are the only province in Canada showing a consistent decline in new HIV diagnoses.”
Pooled NAAT detects the virus as soon as one to two weeks after the virus enters the body, compared to up to four weeks using standard HIV testing. During this very early stage of infection, people have a greater risk of transmitting HIV to others. As most patients with a new diagnosis change their behaviours and access HIV treatment, improving the diagnosis of acute HIV can help prevent new infections and reduce HIV transmission, which also lowers long-term costs to the health care system.
“Accurate, timely test results means reducing the spread of HIV in the gay community,” sayd Dr. Mark Gilbert, physician epidemiologist, Sexually Transmitted Infections, BCCDC, and study co-author. “The sooner people know they have contracted HIV, the sooner their behaviour changes.”
The study also found that the combination of pooled NAAT and social marketing campaigns was found to be highly effective in almost doubling the rate of acute HIV detection in the clinics, resulting in a 12 per cent increase in the total number of HIV diagnoses. In total, 25 men with acute HIV were diagnosed by pooled NAAT who otherwise would have received a negative result.
As a result of the success of the pilot program, the BC Public Health Microbiology and Reference Laboratory will maintain pooled NAAT at these clinic sites in Vancouver following the successful pilot program, and is collaborating with BCCDC to implement the test method at other clinics in the province.
“Expanded HIV testing as part of the treatment-as-prevention approach has proven to be highly effective at improving community health outcomes,” says Dr. Julio Montaner, director for the BC Centre in Excellence in HIV/AIDS. “Earlier detection of HIV means we will be able to engage individuals into life-saving treatment sooner and prevent further HIV transmissions.”
This research was funded through the Canadian Institutes of Health Research and supported through the provincial STOP HIV/AIDS program. The investment of the provincial government in the STOP HIV/AIDS program and initiatives such as this has helped to increase the uptake of HIV testing and diagnosis and has improved the connection to HIV care and treatment.