People with HIV in Ontario living longer, as mortality rate drops more than 70 per cent
Toronto, October 22, 2013
By Leslie Shepherd
The number of people living with HIV in Ontario rose nearly 100 per cent between 1996 and 2009, largely because of the 70 per cent reduction in the number of deaths among these individuals, a new study has found.
The number of new HIV diagnoses was fairly stable over the same period. However, women and people over 50 accounted for an increasing proportion of those new diagnoses, according to researchers at St. Michael’s Hospital.
“The introduction of combination antiretroviral therapy [drugs] means people with HIV are living longer, reflecting the transformation of HIV into a chronic disease characterized by an aging group of patients,” said the study’s author, Dr. Tony Antoniou, a pharmacist and researcher in the hospital’s Department of Family and Community Medicine.
“People with HIV are also increasingly burdened by other illnesses, such as diabetes and high blood pressure, adding to the complexity of their care,” said Dr. Antoniou, who is also an adjunct scientist at the Institute for Clinical Evaluative Sciences.
His study appeared today in the journal Open Medicine.
Dr. Antoniou said his findings have important implications for HIV prevention and public health. The increased relative burden of HIV among women and older people may be mostly due to the decreased rate of new diagnoses among younger men, perhaps reflecting the success of HIV prevention efforts aimed at them.
The study also found it appears that some individuals who test positive for HIV are either unaware that they are infected or do not receive regular follow-up care once diagnosed. These individuals are not benefiting from advances in managing HIV infection.
Dr. Antoniou said that because rates of new HIV infections in British Columbia, Ontario and Quebec have been shown to decline 8 per cent for each 10 per cent increment in antiretroviral treatment coverage, universal coverage of these drugs in Ontario might augment existing prevention programs.
He said that if current trends continue, HIV-related health and support services will have to adapt to the needs of an aging group of patients with multiple illnesses who may require the expertise of health care sectors that have not been traditionally involved in the provision of HIV-related care, such as gerontology and long-term care.
Dr. Antoniou said he had no access to clinical data and information regarding method of HIV acquisition, rendering it impossible to examine trends in relation to risk factors for HIV-infection, stage of illness at the time of diagnosis or country of birth.
Among the specific findings of the study:
- The number of adults living with HIV increased by 98.6 per cent;
- Women accounted for a larger proportion of people with HIV, increasing from 12.8 per cent to 19.7 per cent of total cases;
- People 50 years and older accounted for a higher proportion HIV cases, increasing from 10.4 per cent to 29.9 per cent of total cases;
- Mortality rates among people with HIV decreased by 71.9 per cent.
This study was supported by the Institute for Clinical Evaluative Sciences, which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care.
About St. Michael’s Hospital
St Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.
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