Faster-acting HIV mutation found in Saskatchewan

Researchers have discovered Saskatchewan has mutated strains of HIV that act faster than strains found in the rest of Canada and the United States.

The research was conducted by the B.C. Centre for Excellence in HIV/AIDS and was presented at an AIDS conference in Amsterdam.

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“As a clinician, I think that the work presented in Amsterdam [July 26] helps to provide a biologic explanation for some of the challenging cases that we’ve seen on the ground, specifically in regards to accelerated progression of HIV,” said Dr. Alex Wong, an infectious diseases physician with the Saskatchewan Health Authority.

Wong said doctors in the province have, anecdotally, seen the virus progress a lot more quickly than expected. He said instead of taking five or 10 years to progress, the virus takes only six months to two years.

The multi-year study compared more than 2,300 anonymized HIV gene sequences from Saskatchewan to other strains across North America. It also looked at specific mutations of the human leukocyte antigen alleles, the part of the genetic code that’s responsible for producing a protein that’s used by the immune system to determine if something foreign is infecting a body.

More than 98 per cent of the HIV sequences collected in Saskatchewan between 2015 and 2016 harboured at least one major immune resistance mutation.

What the researchers found was the stronger strains of HIV seemed to be adapted to certain human leukocyte antigen allele mutations that are commonly found in the Indigenous population.

“Put simply, it seems as though the majority of the strains of HIV that we have circulating in our province seem to be specially adapted not for all persons living with HIV in the province, but for our Indigenous populations,” Wong said.

Saskatchewan has the highest HIV rate in the nation, with 170 new cases found in 2016, according to the provincial health ministry. Seventy-nine per cent were Indigenous. The areas of the province with more cases of HIV include the North, Prince Albert and the First Nations reserves near Kamsack. The East Central region has rates lower than the provincial average.

“What this highlights to us is we already know we have a significant challenge with HIV in the province,” Wong said. “We have incidence rates that are much higher than the rest of Canada and certain parts of the province are disproportionately affected compared to others, so it’s clear that funding is required across the board to address the HIV cascade and to look at specifically the regions where the incidence rates are much higher and to try to focus on those areas.”

The mutated strains respond to HIV drug treatments in the same way as other strains, so the earlier the virus is caught through tests, the better the outcome.

“We need to be much more aggressive in terms of testing and in terms of reaching out to high-risk individuals and being much more systematic in engaging people in care,” Wong said.

The infectious diseases physician said he hoped the discovery would result in more clinical and genetic research in the province due to its unique situation.

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