Researchers have detected highly-prevalent, immune-resistant HIV mutations in Saskatchewan.
The researchers were conducting a study for the BC Centre for Excellence in HIV/AIDS (BC-CfE) and Simon Fraser University. The research was in response to reports in Saskatchewan of unusually rapid progression of HIV to AIDS-defining illnesses in the absence of treatment.
The research revealed genetic mutations in the province.
The study was presented on July 26 at the 2018 AIDS conference in Amsterdam and published in the scientific journal AIDS.
The research shows that HIV strains circulating in Saskatchewan have adapted to evade host immune responses.
These strains are being commonly transmitted, and if left untreated, progress rapidly to AIDS-related illnesses.
This is the first molecular epidemiology study of HIV in Saskatchewan and it confirms some of what we have been seeing on the ground,” said Dr. Alex Wong, an infectious disease specialist in Regina with the Saskatchewan Health Authority, researcher at the University of Saskatchewan and an author of the study, in a press release.
Researchers from the centre for excellence, Simon Fraser, the Public Health Agency of Canada (PHAC) and doctors from Saskatchewan, were startled at the prevalence of immune resistance mutations, a press release said.
One mutation was found in more than 80 per cent of Sask. HIV strains, compared with only about 25 per cent of HIV strains found elsewhere in North America.
“The pervasiveness of such mutations is increasing over time,” the press release said.
“More than 98% of the HIV sequences collected in Saskatchewan most recently (between 2015 and 2016) harboured at least one major immune resistance mutation.”
HIV antiretroviral treatment does work as effectively against immune-resistant HIV strains as non-resistant strains. The provincial government recently announced $600,000 to provide universal drug coverage for HIV medications, including antiretroviral therapy.
“The findings of this study are concerning but the good news is, once people get tested, we can get them on life-saving treatment immediately,” said Dr. Zabrina Brumme, Research Scientist with the BC-CfE, Associate Professor in SFU’s Faculty of Health Sciences and the lead author on the study in the press release.
“It is critical for individuals to take action to protect their health, get tested for HIV and access HIV care and treatment immediately following a diagnosis.”
The study compared more than 2,300 anonymized HIV sequences from Saskatchewan with data sets from across the US and Canada. Genetic analysis of the strains found in Canada showed high levels of clustering, which indicates that viruses with similar mutations are frequently and widely transmitted.
“Our finding that immune-resistant HIV strains are being commonly transmitted in Saskatchewan means that it is critical we work together to expand access to HIV testing and treatment,” said Dr. Jeffrey Joy, Research Scientist with the BC-CfE and an author on the study.
“We know that HIV does not stay confined to geographical clusters—it spreads. We need to work together to make HIV testing routine and stigma-free.”
“The discoveries made in this research project are very important for public health purposes as these empower health professionals to better understand transmission dynamics on how HIV is being spread in Saskatchewan,” said Dr. Paul Sandstrom, Director of PHAC’s National HIV and Retrovirology Laboratory and an author on the study.
“This increased understanding will improve the targeting and evaluation of prevention strategies to help stop the spread of the virus.”
HIV rates in Saskatchewan are among the highest in North America. About 80 per cent of infected people self-identify as having Indigenous ancestry.
“These findings add further urgency to addressing the Saskatchewan epidemic, in which infection burden is concentrated among the most marginalized,” said Dr. Julio Montaner, Director of the BC-CfE.
“The global scientific consensus is that HIV treatment should be provided immediately upon diagnosis. We support continued expansion of testing and treatment for HIV in Saskatchewan. Indeed, offering universal access to HIV treatment immediately upon diagnosis has been shown to be a successful and cost-effective treatment as prevention strategy, leading to a consistent decline in HIV/AIDS morbidity and mortality, as well as in new HIV cases.”