Use of CDC Vaccine Schedules Smartphone Application to Prescribe Vaccines for HIV‐Infected Adults
Use of CDC Vaccine Schedules Smartphone Application to Prescribe Vaccines for HIV‐Infected Adults
复制标题
使用 CDC 疫苗计划智能手机应用程序为 HIV 感染者开出疫苗处方
DOI：
10.1016/j.jana.2016.01.006
复制
发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Christopher W. Blackwell
中科院分区：
文献类型：
--
作者：
Christopher W. Blackwell
传染病专家传统上管理成人艾滋病毒感染。然而，由于临床医生治疗HIV感染者的需求超过了不断减少的HIV工作人员，初级保健提供者（PCP），包括医生、执业护士和医生助理，开始在HIV管理中发挥更大的作用（Chu et al.，2015）。这也可能至少部分是由于最近在通过使用有效的抗逆转录病毒疗法对艾滋病毒感染进行药物管理方面取得的进展。较新的复方制剂需要较低的给药频率，不良反应较少，毒性风险较低，因此不需要专家进行更警惕的监测。抗逆转录病毒治疗在延长艾滋病毒感染者预期寿命方面的疗效改变了人们对艾滋病毒的看法，将其更多地定义为一种慢性疾病，而不是与高急性和快速死亡相关的疾病（Griffin，2010）。此外，比较PCP和专家之间的病毒抑制和免疫学成功的成就的少数研究表明，两者之间的结果在统计学上相似（Chu，Umanski，Blank，Grossberg，& Selwyn，2010; Chu等人，2015）。因此，虽然传染病专家继续在艾滋病毒感染的跨学科治疗中发挥重要作用，但PCP也应该认识到他们的重要性，不仅在治疗成人艾滋病毒感染方面，而且在促进这些人的健康方面（Burgess &卡斯滕，2013）。因此，满足这一人群的疫苗需求在初级保健实践中至关重要。
Infectious disease specialists have traditionally managed HIV infection in adults. However, as the need for clinicians to treat those infected with HIVoutpaced a diminishing HIV workforce, primary care providers (PCPs), including physicians, nurse practitioners, and physician assistants, began playing a much greater role in the management of HIV (Chu et al., 2015). This could also be at least partially driven by more recent advances in the pharmacotherapeutic management of HIV infection through the use of effective antiretroviral therapy. Newer combination agents that require less frequent administration, have fewer adverse effects, and have lower risk of toxicity lessened the need for more vigilant monitoring by specialists. The efficacy of antiretroviral therapy in prolonging life expectancy of those infected with HIV altered the perception of HIV, defining it more as a chronic illness rather than one associated with high acuity and rapid mortality (Griffin, 2010). In addition, the few studies that have compared the achievement of viral suppression and immunologic success between PCPs and specialists have shown statistically similar outcomes between the two (Chu, Umanski, Blank, Grossberg, & Selwyn, 2010; Chu et al., 2015). Thus, while infectious disease specialists continue to play a major role in the interdisciplinary treatment of HIV infection, PCPs should also recognize their importance, not only in treating HIV infection in adults, but in promoting wellness in these persons as well (Burgess & Kasten, 2013). Consequently, meeting the vaccine needs of this population is critical in primary care practice.