Brisbane hosts national workshop on early HIV treatment
The HIV Foundation Queensland played host to a national workshop on the weekend to further the message of early HIV treatment as a means of preventing transmission.
The foundation partnered with the Australasian Society for HIV Medicine to host the HIV Earlier Treatment Workshop in Brisbane.
Foundation chair Dr Darren Russell told QP not all doctors have been on board with the ‘treatment as prevention message’, but changes to the Pharmaceutical Benefits Scheme (PBS) will soon make it possible for doctors to prescribe HIV medication to a broader range of patients.
HIV attacks CD4 T cells, which are an important part of the body’s immune system.
Currently only HIV positive people with a T cell count of less than 500 are eligible to access medication through the PBS, the cost of which is subsidised by the federal government.
On April 1 the PBS is removing the T cell count restriction on prescribing, which means all HIV positive people will be able to access subsidised medication.
“This workshop was a way to look at that and to see what that would mean and to plan some educational events around the country,” Russell said.
Russell said some doctors were hesitant to accept the early prescription of HIV medication to patients.
“With some doctors there’s been a split between the person sitting in front of me, the patient with HIV, and the bigger public health ramifications. They think if they’ve got someone with HIV they really should be looking after them; that they shouldn’t worry about other people in the community.
“Whereas there are others of us who think we can help the person in front of us who has HIV and we can think broader than that because if we get that person on treatment we can greatly reduce their risk of passing HIV on to anyone else.”
Russell said older doctors who had experienced the side effects and problems of the AZT era in the late 80s and early 90s, were concerned about early medication of patients.
“Then a whole lot of wonder drugs came along in 1996, but they were hard to take – 20 pills a day, side effects, problems; we didn’t know the long-term benefits or risks. So I think there has been a reticence by some doctors.
“But that’s not the case with most of the HIV positive community, they’re embracing new medications and wanting them.
“The newer drugs have very few side effects, and very good outcomes. And we also know now that if you go on treatment that you don’t transmit.”
Russell cited the recent European ‘Partner’ study, which found most HIV-positive people on antiretroviral treatment have a near zero chance of transmitting the virus to others during unprotected sex.
“That’s pretty exciting stuff,” Russell said. “And this is what we’ve been seeing in clinical practice: going on treatment stops you passing it on to other people.”
Russell said condom use, regular HIV testing and early treatment all help lower HIV transmission rates.
“We were able to refine a lot of the messages and get some educational resources going so we can roll this message out across the country.”
IMAGE: A rapid HIV test can give a result in 15-20 minutes. Photo: A. Shaw