A Failure to Disseminate Transformative Science - HIV Treatment as Prevention, 10 Years On.
A Failure to Disseminate Transformative Science - HIV Treatment as Prevention, 10 Years On.
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DOI：
10.1056/nejmp2113118
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发表时间：
2021-12-16
影响因子：
158.5
通讯作者：
Mayer, Kenneth H.
中科院分区：
文献类型：
--
作者：
Bor, Jacob;Onoya, Dorina;Richman, Bruce;Mayer, Kenneth H.
在全球范围内扩大艾滋病毒治疗是21世纪世纪公共卫生领域最伟大的成功故事之一。数百万艾滋病毒感染者的寿命更长，生活更健康，因为已经部署了大量资源来增加获得药物的机会。尽管人们普遍认识到治疗的治疗益处，但最近的研究显示，全球对治疗作为预防的疗效（TasP）的认识存在巨大差异。2对TasP的了解在撒哈拉以南非洲特别有限，那里是所有艾滋病毒感染者的三分之二。尽管越来越多的证据表明共享这些信息具有临床和公共卫生效益，但支持TasP的科学尚未得到广泛传播。在HPTN 052中，研究人员随机分配血清状态不一致的夫妇中的HIV感染者立即或延迟抗逆转录病毒治疗（ART），并比较了最初HIV阴性伴侣中的HIV发病率。2011年8月发表的结果证明了许多临床医生和科学家长期以来的怀疑：导致病毒抑制的艾滋病毒治疗在预防艾滋病毒传播方面非常有效。1大型队列研究-PARTNER，PARTNER 2和Opposites Attract-证实了这一结果，发现没有与126，000次无安全套性行为相关的传播：换言之，零风险。
The global scale-up of HIV treatment is one of the great public health success stories of the 21st century. Millions of people with HIV are living longer and healthier lives because of the substantial resources that have been deployed to increase access to medication. Despite widespread awareness of treatment’s therapeutic benefits, however, recent research revealed large global disparities in knowledge about the efficacy of treatment as prevention (TasP). 2 Knowledge of TasP is particularly limited in sub-Saharan Africa, which is home to two thirds of all people with HIV. The science supporting TasP has not been widely disseminated, despite growing evidence that sharing this information has clinical and public health benefits.In HPTN 052, investigators randomly assigned people with HIV in serostatus-discordant couples to immediate or deferred antiretroviral therapy (ART) and compared HIV incidence among the originally HIV-negative partners. The results, published in August 2011, demonstrated what many clinicians and scientists had long suspected: that HIV treatment leading to viral suppression is highly effective in preventing HIV transmission. 1 Large cohort studies—PARTNER, PARTNER 2, and Opposites Attract—confirmed this result, finding no transmissions associated with a combined 126,000 condomless sex acts: in other words, zero risk.