As community viremia declines, so does HIV incidence, study finds
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As community viremia declined, so did the incidence of HIV infection among gay and bisexual men in a 6-year Australian study, researchers reported.
The findings, presented during CROI, provide “compelling evidence that treatment as prevention can achieve population-level ‘big picture’ public health goals around reducing new cases of HIV among gay and bisexual men,” Denton Callander, PhD, senior research fellow at the University of New South Wales’ Kirby Institute in Sydney and research scientist at the Columbia University Mailman School of Public Health, told Healio.
“We’ve known for some time now that HIV treatment can prevent onward transmission of the virus at an individual level,” Callander said. “The question, however, is if this strategy can achieve ‘big picture’ public health goals — namely, to reduce new HIV infections. This study was created to try to answer that question by looking specifically at the relationship over time between ‘community viremia’ and new diagnoses of HIV among gay and bisexual men, the population most affected by HIV in Australia and many other parts of the world.”
Callander and colleagues established a longitudinal cohort of HIV-positive and HIV-negative gay and bisexual men using data from a surveillance system of 49 sexual health clinics, general practices, community HIV-testing sites and hospitals from 2012 to 2017. According to the study, among those diagnosed with HIV, the annual prevalence of viremia was calculated using each participants’ last viral load test of the calendar year, whereas a model was used to estimate the proportion of HIV-positive gay and bisexual men living with undiagnosed HIV infection.
Results of the study showed that as HIV viremia among diagnosed gay and bisexual men decreased from 27.9% to 3.7% over the course of the study, the proportion of this population living with undiagnosed HIV decreased from 10% to 8.4%. In addition, the annual community prevalence of HIV viremia decreased from 28.6% to 12.8%, whereas HIV incidence decreased from 0.88 per 100 person-years to 0.22 per 100 person-years.
“It’s an exciting finding with implications in many parts of the world, and it is one more reason for governments and health bodies to do everything they can to provide access to treatment for all people living with HIV,” Callander said.
According to the study, the correlation coefficient between annual community prevalence of viremia and HIV incidence from 2012 to 2017 was 0.94, and it was 0.90 for 2012 to 2015.
“Clinicians should continue to talk to their patients about HIV treatment as soon as possible after diagnosis and make sure that they are supported to maintain it over time,” Callander concluded. “Patients living with HIV should know that treatment is not only important for maintaining their own health but being on it helps toward the ultimate goal of HIV elimination.” – by Caitlyn Stulpin
Reference:
Callander D, et al. Abstract 48. Presented at: Conference on Retroviruses and Opportunistic Infections; March 8-11, 2020; Boston.
Disclosures: Callander reports no relevant financial disclosures.
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