A Global Research Agenda for Pediatric HIV
A Global Research Agenda for Pediatric HIV
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DOI：
10.1097/qai.0000000000001743
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发表时间：
2018-08-15
影响因子：
3.6
通讯作者：
Doherty, Meg
中科院分区：
文献类型：
--
作者：
Penazzato, Martina;Irvine, Cadi;Doherty, Meg
背景：尽管取得了进展，但2016年仍有16万儿童新感染，12万儿童死于艾滋病。关于如何最好地诊断、治疗和向感染艾滋病毒的儿童提供服务的证据差距仍然存在。世卫组织和密码研究所进行了一项全球研究优先排序工作，以便在资源减少的情况下集中研究工作。方法：根据Irvine等人的描述，采用了儿童健康和营养研究倡议的方法。1专家组对结果进行了审查，并确定了5个优先主题，包括检测、抗逆转录病毒治疗和服务提供，考虑到现有政策、已发表的文献和正在进行的研究。结果：来自62个国家的269人共提交了749个问题。对于艾滋病毒检测，优先主题包括改善获得、接受和联系护理的战略和干预措施，包括使用新的诊断工具和产前护理以外的切入点。在治疗方面，重点包括改善依从性、短期和长期结果以及合并感染的管理、最佳药物配方和早期抗逆转录病毒治疗的战略。在提供服务方面，优先事项包括改善获得、接受和保留护理的战略或干预措施，包括社会心理和家庭支持以及艾滋病毒披露和减少耻辱和歧视的方法。结论：这是针对艾滋病毒开展的规模最大的儿童健康和营养研究倡议活动。研究结果为今后儿科HIV研究提供了指导。迫切需要全球承诺支持优先研究、充分投资和强有力的领导，以改善感染艾滋病毒和受其影响的儿童的健康和福祉。
Background: Despite progress, 2016 still saw 160,000 new infections and 120,000 AIDS-related deaths among children. Evidence gaps on how to best diagnose, treat, and deliver services to children living with HIV remain. A global research prioritization exercise was undertaken by WHO and CIPHER to focus research efforts in the context of diminishing resources.Methods: The Child Health and Nutrition Research Initiative methodology was adapted and used, as described by Irvine et al. 1 Outcomes were reviewed by an expert group and 5 priority themes identified for testing, antiretroviral treatment, and service delivery, accounting for existing policies, published literature and ongoing research.Results: A total of 749 questions were submitted by 269 individuals from 62 countries. For HIV testing, priority themes included strategies and interventions to improve access, uptake and linkage to care, including with novel diagnostic tools and entry points beyond antenatal care. For treatment, priorities included strategies to improve adherence, short-and long-term outcomes and management of coinfections, optimal drug formulations, and early ART. For service delivery, priorities included strategies or interventions to improve access, uptake and retention in care, including psychosocial and family support and approaches to HIV disclosure and reduction of stigma and discrimination.Conclusions: This is the largest Child Health and Nutrition Research Initiative exercise undertaken in HIV. The results provide guidance to focus future research in pediatric HIV for impact. Global commitment to support priority research, adequate investment, and strong leadership is urgently needed to improve the health and wellbeing of children living with and affected by HIV.