The Georgia Straight

Vancouver physician remains the king of HAART

- By Charlie Smith

More than three decades before the COVID-19 pandemic, there was another viral scourge stalking the world. HIV, a.k.a. the human immunodefi­ciency virus, was killing gay men, hemophilia sufferers, intravenou­s-drug users, and residents of southern African countries at frightenin­g rates.

By 2020, approximat­ely 36.3 million people had been killed by this retrovirus. Wednesday (December 1) marked World AIDS Day to emphasize the impact of the pandemic and support equitable treatment for those living with HIV.

The first official reporting of what came to be known as AIDS occurred on June 5, 1981. That’s when a research paper chronicled the symptoms of five gay men from 29 to 36 years old with Pneumocyst­is carinii pneumonia in Los Angeles.

“The patients did not know each other and had no known common contacts or

knowledge of sexual partners who had had similar illnesses,” the paper stated.

Less than a month later, there was a report linking Kaposi’s sarcoma and Pneumocyst­is pneumonia to 26 gay men in New York and California.

By 1985, when actor Rock Hudson disclosed his AIDS diagnosis, the disease was dominating headlines around the world, in part because there was no cure. Bloodscree­ning guidelines were issued, but the death count continued to rise.

From 1987 to 1992, AIDS was the leading cause of potential years of life lost among men in Vancouver, Toronto, and Montreal, according to a paper by Simon Fraser University heath researcher Robert Hogg. In response to all of the deaths, an internatio­nal grassroots group, ACT UP [AIDS Coalition to Unleash Power), started employing direct-action tactics to demand greater access to experiment­al drugs.

The first substantia­l decline in AIDS deaths in the United States did not occur until 1997, largely thanks to highly active antiretrov­iral therapy, a.k.a. HAART. And the king of HAART, according to a 2006 article in the Lancet, was Vancouver physician Julio Montaner. He’s executive director and physician-in-chief of the B.C. Centre for Excellence in HIV/AIDS.

“Montaner’s early research focused on the respirator­y complicati­ons of AIDS and later shifted towards antiretrov­iral therapy for HIV infection,” wrote Angela Pirisi in the Lancet. “In the mid 1990s, he championed the use of highly active antiretrov­iral therapy (HAART), turning it into a standard of care for AIDS patients.

“Another of Montaner’s contributi­ons has been setting up HIV/AIDS treatment cohorts and showing their role in developing evidence of clinical outcomes.”

Thanks to Montaner and other researcher­s, AIDS has been transforme­d from a probable death sentence into a chronic disease. He has long advocated treatment as prevention to suppress viral loads.

Since the peak of 1997, new infections of HIV have fallen by 52 percent, according to UNAIDS. Mortality from the disease has fallen 53 percent among women and 41 percent among men and boys since 2010.

 ?? ?? In the 1990s, Dr. Julio Montaner helped turn AIDS into a very manageable chronic illness.
In the 1990s, Dr. Julio Montaner helped turn AIDS into a very manageable chronic illness.

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