HIV treatment as prevention (TasP) works well, and it should be considered the next standard of care, declared Julio Montaner, M.D., and others at the opening session of IAS 2015 in Vancouver, Canada.
Montaner, the director of the British Columbia Centre for Excellence in HIV/AIDS, used his speech to reflect on how far HIV science and treatment access have come since 1996, the last time the International AIDS Conference was in Vancouver. It was shortly after that conference that highly active antiretroviral therapy -- treatment with multiple classes of effective medications -- became the standard of HIV care, and went on to save millions of lives, Montaner said.
"We have 15 million people on treatment. So many said it couldn't be done, but yes we did," Montaner said.
He pointed to the concept of treatment as prevention as the next key evolution in HIV management strategy. IAS 2015 hopes to be a milestone conference on that front, as the final results from a study known as HPTN 052 are expected to strongly show that antiretroviral therapy works to reduce sexual transmission of HIV by over 95% in serodiscordant couples. Additionally, the first full presentation of results from the START study are expected to detail how starting HIV treatment immediately, regardless of CD4 count, greatly reduces the risk of death and various complications.
Montaner also shared a letter he had received from Archbishop Pietro Parolin, the Vatican Secretary of State, passing along Pope Francis' regards. The letter expressed gratitude and esteem for the hard work behind advances in HIV research -- in particular, for lifesaving antiretroviral therapy and more recent developments in the field of HIV treatment as prevention. It also expressed hope that the fruits of such research could be made more available to the world's poorest people.
"If he gets it, why doesn't everyone get it?" Montaner asked the audience after reading the letter aloud.
Finally, Montaner urged attendees to sign the newly unveiled Vancouver Consensus, which aims to galvanize the HIV community around the idea of turning HIV science into action, and calls for governments to be held accountable for delivering treatment to everybody living with HIV. "You're either with us or against us," Montaner said.
The message of universal treatment access was echoed throughout the IAS 2015 opening session. In a speech later in the evening, Michel Sidibé, the executive director of UNAIDS, echoed many of Montaner's sentiments. He referred to the 90-90-90 UNAIDS target, which establishes 2020 as a target date by which 90% of all people with HIV worldwide would know their status, 90% of diagnosed people would be on sustained treatment, and 90% of people on treatment would be virally suppressed.
Sidibé passionately called for the adoption of HIV "treatment for everyone, everywhere, right now, as a fundamental human right."
Additional reporting for this article was provided by Myles Helfand.