HIV treatment as prevention: natural experiments highlight limits of antiretroviral treatment as HIV prevention.
HIV treatment as prevention: natural experiments highlight limits of antiretroviral treatment as HIV prevention.
复制标题
DOI：
10.1371/journal.pmed.1001231
复制
发表时间：
2012
期刊：
影响因子：
15.8
通讯作者：
Wilson DP
中科院分区：
文献类型：
--
作者：
Wilson DP
人们越来越热衷于扩大艾滋病毒感染者抗逆转录病毒治疗的覆盖面，以防止持续传播。将治疗作为预防在现实世界人群中实施时将面临许多障碍，这可能会导致该策略的有效性低于乐观的建模情景或理想的临床试验环境所提出的效果。在一些地区，作为其预防和治疗战略的一部分，已经实现了艾滋病毒检测和抗逆转录病毒疗法的使用率（病毒抑制水平很高），这是许多国家希望作为治疗即预防战略的目标。这篇综述考察了许多这样的“自然实验”，即不列颠哥伦比亚省、旧金山、法国和澳大利亚，以提供关于治疗作为预防是否在现实世界人群中起作用的评论。这项审查表明，这一战略对人口水平的影响可能比从理想条件推断的要小得多。
There is growing enthusiasm for increasing coverage of antiretroviral treatment among HIV-infected people for the purposes of preventing ongoing transmission. Treatment as prevention will face a number of barriers when implemented in real world populations, which will likely lead to the effectiveness of this strategy being lower than proposed by optimistic modelling scenarios or ideal clinical trial settings. Some settings, as part of their prevention and treatment strategies, have already attained rates of HIV testing and use of antiretroviral therapy—with high levels of viral suppression—that many countries would aspire to as targets for a treatment-as-prevention strategy. This review examines a number of these “natural experiments”, namely, British Columbia, San Francisco, France, and Australia, to provide commentary on whether treatment as prevention has worked in real world populations. This review suggests that the population-level impact of this strategy is likely to be considerably less than as inferred from ideal conditions.
登录
查看更多内容
影响因子：
12.7
作者：
Branson, Bernard
通讯作者：
Branson, Bernard
影响因子：
3.6
作者：
Dodds, Julie P.;Johnson, Anne M.;Mercey, Danielle E.
通讯作者：
Mercey, Danielle E.
影响因子：
1.6
作者：
Falster, Kathleen;Gelgor, Linda;Law, Matthew
通讯作者：
Law, Matthew
影响因子：
3.8
作者：
Fisher, Martin;Pao, David;Pillay, Deenan
通讯作者：
Pillay, Deenan
影响因子：
3.7
作者：
Das M;Chu PL;Santos GM;Scheer S;Vittinghoff E;McFarland W;Colfax GN
通讯作者：
Colfax GN