Expanded access to highly active antiretroviral therapy: A potentially powerful strategy to curb the growth of the HIV epidemic
Expanded access to highly active antiretroviral therapy: A potentially powerful strategy to curb the growth of the HIV epidemic
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DOI：
10.1086/588673
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发表时间：
2008-07-01
影响因子：
6.4
通讯作者：
Montaner, Julio S. G.
中科院分区：
文献类型：
--
作者：
Lima, Viviane D.;Johnston, Karissa;Montaner, Julio S. G.
我们开发了一个数学模型，使用多源感染框架，以评估在医疗需要的人中扩大高效抗逆转录病毒治疗（HAART）覆盖范围对人类免疫缺陷病毒（HIV）检测新阳性的人数和相关费用的潜在影响，在加拿大不列颠哥伦比亚省，在未来25年。该模型使用回顾性数据进行了校准，这些数据描述了该省抗逆转录病毒治疗的利用情况和艾滋病毒检测新阳性的个人。不同的情况下进行了调查的基础上不同的假设，耐药性，坚持HAART，治疗指南，HAART覆盖的程度，HAART摄取的时间。高效抗逆转录病毒疗法的推广导致艾滋病毒流行病的增长和相关费用的大幅下降。这些结果提供了强大的额外动力，以加速推出HAART计划积极针对那些有医疗需要的人，既为自己的利益，并作为减少新的艾滋病毒感染的一种手段。
We developed a mathematical model using a multiple source of infection framework to assess the potential effect of the expansion of highly active antiretroviral therapy (HAART) coverage among those in medical need on the number of individuals testing newly positive for human immunodeficiency virus (HIV) and on related costs in British Columbia, Canada, over the next 25 years. The model was calibrated using retrospective data describing antiretroviral therapy utilization and individuals testing newly positive for HIV in the province. Different scenarios were investigated on the basis of varying assumptions regarding drug resistance, adherence to HAART, therapeutic guidelines, degree of HAART coverage, and the timing of HAART uptake. Expansion of HAART lead to substantial reductions in the growth of the HIV epidemic and related costs. These results provide powerful additional motivation to accelerate the roll out of HAART programs aggressively targeting those in medical need, both for their own benefit and as a means of decreasing new HIV infections.