1 st International Treatment as Prevention (TasP) Workshop Overview British Columbia Centre for Excellence in HIV/AIDS Julio Montaner MD, DSc(hon), FRCPC,

Slides:

Advertisements

Similar presentations

Antiretroviral Therapy: An HIV Prevention Strategy? Wafaa El-Sadr, MD, MPH Columbia University Harlem Hospital New York.

Advertisements

Julio Montaner, MD Professor of Medicine, and Head, Div. of AIDS, University of British Columbia Director, BC-Centre for Excellence in HIV/AIDS at Providence.

Page 1 Peer-delivered HIV testing and counseling among people who inject drugs in Bangkok, Thailand Lianping Ti 1 Kanna Hayashi 1,2 Karyn Kaplan 3 Paisan.

Slide 1 of 42 IAS–USA Treatment as Prevention: Evaluating the Impact of HAART Expansion The British Columbia (BC) Experience AU EDITED FINAL:

Women and ARV-based Prevention: Challenges and Opportunities Tim Mastro, MD, DTM&H AIDS 2014 Melbourne, Australia 24 July 2014.

Using longitudinal, population-based HIV surveillance to measure the real-world impacts of ART scale-up in KwaZulu- Natal, South Africa Frank Tanser Presentation.

The HIV Engagement in Care Cascade Edward Gardner, MD Associate Professor of Medicine Denver Public Health University of Colorado Denver.

Monica Gandhi MD, MPH Associate Professor and Women’s HIV Clinic provider, HIV/AIDS Division San Francisco General Hospital/ UCSF Safe Poz Love, U.S. Positive.

Offering ARV Treatment to All HIV-infected Persons in San Francisco Grant Colfax, MD Director of HIV Prevention and Research San Francisco Department of.

The hidden HIV epidemic: what do mathematical models tell us? The case of France Virginie Supervie, Jacques Ndawinz & Dominique Costagliola U943 Inserm.

Treatment as prevention (TASP) for HIV and HCV: The evidence and modelling Peter Vickerman.

Maurice Cook ( EM Designs Group, Inc.) The End of AIDS Transmission? Robert M Grant, June 2012.

TasP is not enough Stipulated that TasP is effective in reducing infectiousness of the treated person – But much more is required. TasP requires effective.

Are people living with HIV less likely to pass HIV to others if they are on treatment? Exploring the use of treatment as prevention James Wilton Project.

Long Term Management of HIV Infection in Aging Adults: Current Challenges, Future Strategies Andrew Zolopa, MD Stanford University.

The potential and challenges of ARV-based HIV prevention: An overview

Undetectable = Uninfectious ? Treatment as Prevention.

Community viral load and newly reported HIV infections in Switzerland Matthias Egger Professor of Epidemiology & Public Health Institute of Social and.

Routine HIV Screening in Health Care Settings David Spach, MD Clinical Director Northwest AIDS Education and Training Center Professor of Medicine, Division.

Routine HIV Screening in Health Care Settings David Spach, MD Clinical Director Northwest AIDS Education and Training Center Professor of Medicine, Division.

Bernard M. Branson, M.D. Associate Director for Laboratory Diagnostics Divisions of HIV/AIDS Prevention National Center for HIV/AIDS, Viral Hepatitis,

Treatment as prevention: a new paradigm for HIV control? Richard Hayes.

Conditional Cash Transfers and Contingency Management Strategies in Substance Users Mark Hull MD, MHSc, FRCPC Clinical Assistant Professor, University.

ART Regimen Selection and Treatment Initiation for PMTCT Programs Lara Stabinski, MD, MPH Medical Officer Clinical Services S/GAC June 18, 2012.

Page 1 HIV Treatment-as-Prevention (TasP) for people who use illicit drugs and implications for HCV TasP: The North American experience M-J MILLOY Research.

Changes in population-level HIV RNA distribution one year after implementation of key components of an HIV ‘test and treat’ strategy in rural Uganda Vivek.

What do models estimate to be the impacts on HIV incidence of various percentages of people with HIV on ART ? National AIDS Trust Treatment as Prevention.

Page 1 Social and socio-economic benefits of antiretroviral therapy adherence among HIV-infected people who use illicit drugs in Vancouver, Canada Lindsey.

IAS–USA When to Start Antiretroviral Therapy Constance A. Benson, MD Professor of Medicine University of California San Diego FINAL: Presented.

Population-based impact of ART in high HIV prevalence settings Marie-Louise Newell Professor of Global Health Faculty of Medicine, Faculty of Social and.

1 Dose-response relationship between incarceration and non- adherence to HAART among injection drug users in a Canadian setting M-J Milloy 1,2, T Kerr.

Using HIV Surveillance to Achieve High Impact Prevention Irene Hall, PhD, FACE AIDS 2012 High-Impact Prevention: Reducing the HIV Epidemic in the United.

Jason Andrews, MD, SM, DTM&H Division of Infectious Diseases Massachusetts General Hospital Harvard Medical School International AIDS Society July 2, 2013.

Page 1 Increasing rates of earlier antiretroviral treatment associated with elevated levels of optimal virologic response among HIV-positive illicit drug.

ART for Prevention From Evidence to Action Wafaa El-Sadr, MD, MPH ICAP-Columbia University.

Myron S. Cohen, MD Associate Vice Chancellor Director, Institute for Global Health The University of North Carolina.

Slide 1 of 42 IAS–USA AU EDITED FINAL: Julio Montaner, MD Professor of Medicine, and Head, Div. of AIDS, University of British Columbia Director,

Washington D.C., USA, July 2012www.aids2012.org Equal behaviors, unequal risks: The role of partner transmission potential in racial HIV disparities.

Antiretroviral Treatment Monitoring: A Canadian Case Example Antiretroviral Treatment Monitoring: A Canadian Case Example Robert Hogg, PhD BC Centre for.

British Columbia Centre for Excellence in HIV/AIDS Julio Montaner MD, FRCPC, FCCP, FRSC Director, BC-Centre for Excellence on HIV/AIDS, Providence Health.

David Dowdy, Elvin Geng, Katerina Christopoulos, James Kahn, C. Bradley Hare, Daniel Wlodarczyk, Diane Havlir Internal Medicine Residency Program, UCSF.

Implementation of HIV Treatment as Prevention in China Yan Zhao MD National Center for AIDS/STD Control & Prevention Chinese Center for Disease Control.

Phylodynamically Estimated HIV Diversification Rates Reveal Prevention of HIV-1 by Antiretroviral Therapy Jeffrey B. Joy, Richard H. Liang, Rosemary M.

HIV-infected subjects with CD4 350 to 550 cells/mm serodiscordant couples HPTN 052 Study Design Immediate ART CD Delayed ART CD4

ART: When to Start? – Case Discussion Roy M. Gulick, MD, MPH Professor of Medicine Chief, Division of Infectious Diseases Weill Medical College of Cornell.

1 The impact of ongoing illicit drug use on virologic suppression in HIV-infected injection drug users receiving HAART Authors: Harout Tossonian, Jesse.

Where are we in HIV reduction among gay, bisexual, and other men who have sex with men? Barry D Adam University Professor Senior Scientist & Director of.

School of Public Health and Community Medicine How policies and repressive law- enforcement fuel the HIV epidemic among people who inject drugs Professor.

Understanding temporal trends in HIV prevalence, incidence and ARV Dr Valerie Delpech Head of HIV surveillance Public Health England.

HIV and STI Department, Health Protection Agency - Colindale HIV and AIDS Reporting System The threshold for an ART secondary prevention effect on HIV.

High-impact interventions. Number of people living with HIV who were not receiving antiretroviral therapy, 2014 and 2015 Source: UNAIDS estimates, 2014.

Getting to Zero: Will San Francisco be the first city to succeed? Diane Havlir, MD, Professor of Medicine, UCSF, Chief HIV San Francisco General Hospital.

The investment framework - Critical enablers are not a luxury! Bernhard Schwartlander.

Michael J. Mugavero, MD, MHSc Associate Professor of Medicine University of Alabama at Birmingham Birmingham, Alabama Elements of the Care Continuum FORMATTED:

Page 1 Social and socio-economic benefits of antiretroviral therapy adherence among HIV-infected people who use illicit drugs in Vancouver, Canada Lindsey.

The HIV epidemic in Ontario: 2004 update Robert S. Remis, MD, MPH, FRCPC Ontario HIV Epidemiologic Monitoring Unit Department of Public Health Sciences,

Alcohol and AIDS: A New Decade Grantsmanship Workshop XIX International AIDS Conference Rome, Italy Kendall J. Bryant, Ph.D., NIAAA Alcohol and AIDS Research.

Grinsztejn B, et al, Lancet Infect Dis, March 4 th 2014 PRIMARY COMBINED M&M OUTCOME FIRST AIDS DEFINING EVENT FIRST TB EVENT DEATH.

The Spectrum of Engagement in HIV Care at the Northwest Pennsylvania Rural AIDS Alliance By: Tyler Kitzmiller.

Figure 2: Trends in currently prescribed antiretroviral therapy % prescribed HAART increased from 74% to 83% Trends in ART use, HIV viral load, and CD4.

3 April 2003 Treatment as prevention: why? Gus Cairns Editor, HIV Treatment Update.

Estimating the population impact of homelessness on HIV viral suppression among people who use drugs Brandon DL Marshall, 1 Beth Elson, 1 Sabina Dobrer,

Dr. William P. Howlett Matthew P. Rubach, MD Dr. Neema W. Minja Department of Internal Medicine, KCMC KCMC/Duke Collaboration HIV in Tanzania: Current.

Prevention Science Gaps and the HIV/AIDS Pandemic Quarraisha Abdool Karim, PhD Head: CAPRISA Women and AIDS Pogramme Associate Professor in Epidemiology,

Entry into care Failure to initiate timely HIV care after diagnosis is common ~75% of newly diagnosed link to care within 6-12 months Delayed entry into.

Hepatitis C in the HIV-infected patient

Projected new adult infections and total adult deaths in sub-Saharan Africa, in millions, by the year 2020: Impact of three scenarios compared to baseline.

The HIV Epidemic among People who Inject Drugs

Kevin M De Cock MD CDC Kenya Nairobi, September 21, 2003

Geneva, Switzerland June 2002

Presentation transcript:

1 st International Treatment as Prevention (TasP) Workshop Overview British Columbia Centre for Excellence in HIV/AIDS Julio Montaner MD, DSc(hon), FRCPC, FCCP, FRSC, OBC Director, BC-Centre for Excellence on HIV/AIDS, Providence Health Care Professor of Medicine and Head, Division of AIDS, University of British Columbia Past-President, International AIDS Society

Additional Industry Support: British Columbia Centre for Excellence in HIV/AIDS

Treatment as Prevention vs ARV Chemoprophylaxis

Integrating HIV prevention and treatment: From slogans to impact Salomon JA, Hogan DR, Stover J, Stanecki KA, Walker N, et al. (2005). PLoS Med 2(1): e16 Sub Saharan Africa

Treatment as Prevention Heterosexual Couples

HIV Incidence (per 100-person-years) 2.24 ( ) 0.37 ( ) HIV Partner Had Started HAART NoYes 92% Reduction Donnell D, et al. Lancet. 2010;375:

HPTN 052 ( HR = 0.37 or 96.3% reduction in transmission No difference whether index pt was M or F Deferred Immediate M Cohen et al, NIH Press Conference May 12 th To be presented at IAS-Rome, July 2011 %

HPTN 052 ( Extra-Pulmonary TB Deferred : 17 cases Immediate : 3 cases 84% Reduction Deferred Immediate M Cohen et al, NIH Press Conference May 12 th To be presented at IAS-Rome, July 2011 %

Treatment as Prevention MSM

Determinants of HIV-1 Transmission in MSM: A Combined Clinical, Epidemiological and Phylogenetic Approach

Treatment as Prevention IDUs

Wood et al, BMJ, 2009 Whiskers represent 95% confidence intervals.

Wood et al, BMJ, 2009 Whiskers represent 95% confidence intervals.

HAART Reduces HIV incidence in IDUs G Kirk, …, D Vlahov for the Alive Cohort, CROI 2011 HIV Incidence Community pVL % Injecting % on HAART

HAART Reduces HIV incidence in IDUs G Kirk, …, D Vlahov for the Alive Cohort, CROI 2011 From 1997, HIV incidence decreased by 74% (IRR 0.26, ) for each log decline in community pVL In a separate model, HIV incidence decreased by 5% (3-8%) for each 1% increase in the proportion of HAART treated patients For the entire follow up period, for each 1% decline in the proportion of HIV+ patients actively injecting, there was a 3% decline in HIV incidence. - However, this effect was largely restricted to the pre-HAART era

Tuesday Feb 8 th 2011

Treatment as Prevention Population Based Studies

Community Viral Load and New HIV Cases in SFco Das M, Chu PL, Santos G-M, Scheer S, Vittinghoff E, et al. Decreases in Community Viral Load Are Accompanied by Reductions in New HIV Infections in San Francisco. PLoS ONE (6): e doi: /journal.pone n=12,512 unduplicated HIV-positive individuals.

Treatment as Prevention Next Steps

The authors estimated that only about 19% of HIV infected individuals in the USA have an undetectable HIV-1 RNA level Spectrum of Engagement in HIV Care - USA Gardner E, McLees M, Steiner J, del Rio C, Burman W, Clin Infect Dis. (2011) 52 (6):

Spectrum of Engagement in HIV Care - USA Gardner E, McLees M, Steiner J, del Rio C, Burman W, Clin Infect Dis. (2011) 52 (6):

Montaner J, The Lancet, Vol 378: July 16 th 2011, pages