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Simon Fraser University health sciences professor Robert Hogg, who is internationally known for his understanding of infectious diseases, will head Canada’s first nation-wide HIV/AIDS antiretroviral research network. The Canadian Observational Cohort (CANOC) will study the effectiveness of antiretroviral therapy for HIV/AIDS treatment.

Hogg predicts that the network’s research will significantly improve treatments for the 58,000 people living with HIV in Canada. Hogg, the director of the Drug Treatment Program at the B.C. Centre for Excellence in HIV/AIDS, notes that new infections are occurring everyday, particularly among First Nations people.

“Society is spending millions of dollars on antiretroviral drugs and studies show that they are transforming AIDS from being a death sentence into a manageable disease,” observes Hogg. “Until now there has been no national network of researchers to provide a big picture of how antiretroviral drugs affect different populations and what could be the best therapy regimen for them.”

Funded by a $2.5 million grant over five years from the Canadian Institutes of Health Research, CANOC brings together 31 HIV/AIDS clinicians and researchers in B.C., Ontario and Quebec.

They will pool the results of their studies of six cohorts of 18,000 HIV-positive Canadians who are receiving antiretroviral treatment. Their goal is to establish an internationally recognized research program in HIV treatment that will better inform doctors and persons living with HIV/AIDS.

“This big picture approach will enable Canadian governments and their respective health agencies to better understand current gaps in knowledge, treatment outcomes and regional trends,” says Hogg.

“The collaboration will also better inform best-practice guidelines for the treatment of HIV/AIDS within various populations, including the gay community, injection drug users and First Nations people. It will also rear a new breed of health practitioners with a deeper understanding of how compounding problems such as mental illness and addiction undermine the efficacy of antiretroviral drugs.”

Until now there has been no mechanism in place to train future researchers in HIV/AIDS cohort research. Meeting the healthcare needs of HIV-positive people in Canada will cost up to $42 billion over their lifetimes. Despite major funding commitments from government agencies, Canada has a limited understanding of HIV/AIDS treatment.

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Backgrounder: New network will improve HIV/AIDS treatment

—    The BC Centre for Excellence in HIV/AIDS (the Centre) will oversee and coordinate many aspects of the collaboration. The Centre is seeking funding from other national and American agencies to finance additional cohort sites outside of B.C., Ontario and Quebec.

—    CANOC will help address the rising HIV infection rate among First Nations people; it will also investigate why 40 percent of people eligible for antiretroviral therapy are not accessing it. CANOC’s research will help clarify the efficacy of antiretrovirals in reducing the infectiousness of HIV-positive people.

—    Antiretroviral therapy can fail largely because of the development of resistant viral strains. Up to 80 percent of HIV-positive individuals with detectable viral loads can develop some degree of drug resistance. In B.C., a study of 1,191 patients on antiretrovirals found that 25 percent had developed drug resistance during the first 30 months of therapy. CANOC is the first national research group to investigate primary and secondary drug resistance.

—    HIV/Hepatitis C virus co-infection can compromise antiretroviral tolerance and jeopardize effective clinical care. National surveillance of treatment outcomes will lead to improved clinical management of this patient group.

—    Key Objectives: 1) Develop a nationally and internationally recognized and policy-relevant program of research in HIV therapeutics and population and public health 2) Establish training and research opportunities for graduate students, post-doctoral fellows and clinicians across the country interested in HIV/AIDS cohort research 3) Improve research dissemination to physicians and persons living with HIV disease and improve the translation of research on HIV/AIDS therapeutics into provincial, national and international treatment guidelines.

—    Key partners involved in five CANOC studies: Ontario HIV Treatment Network, Clinique Médicale l’Actuel, Montreal Chest Institute Immunodeficiency Service Cohort, the Electronic Antiretroviral Therapy (EARTH) and the Canadian HIV-HCV Co-infection Cohort Study.

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