The Human Immunodeficiency Virus Continuum of Care in European Union Countries in 2013: Data and Challenges
The Human Immunodeficiency Virus Continuum of Care in European Union Countries in 2013: Data and Challenges
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DOI：
10.1093/cid/cix212
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发表时间：
2017-06-15
影响因子：
11.8
通讯作者：
Porter, Kholoud
中科院分区：
文献类型：
--
作者：
Gourlay, Annabelle;Noori, Teymur;Porter, Kholoud
背景联合国艾滋病毒/艾滋病联合规划署（艾滋病规划署）制定了到2020年遏制人类免疫缺陷病毒（艾滋病毒）流行的“90-90-90”目标，但用于评估各国是否达到这一目标的方法没有标准化，阻碍了比较。通过欧洲疾病预防和控制中心（ECDC）与欧洲艾滋病毒队列和监测机构的合作，我们为11个欧盟国家构建了2013年标准化的4阶段艾滋病毒护理连续体。阶段定义为（1）截至2013年底该国艾滋病毒感染者的人数;（2）曾被诊断为第1阶段的比例;（3）曾开始抗逆转录病毒治疗的第2阶段的比例;（4）病毒抑制的第3阶段的比例（所有阶段均≥ 90%，超过一半的人至少在1个阶段达到≥ 90%）。欧盟国家正在接近90-90-90的目标。减少未确诊的比例仍然是实现这一目标的最大障碍，这表明需要进一步努力提高艾滋病毒检测率。标准化方法以获得可比的连续护理仍然是一项挑战。
Background. The Joint United Nations Programme on HIV/AIDS (UNAIDS) has set a "90-90-90" target to curb the human immunodeficiency virus (HIV) epidemic by 2020, but methods used to assess whether countries have reached this target are not standardized, hindering comparisons.Methods. Through a collaboration formed by the European Centre for Disease Prevention and Control (ECDC) with European HIV cohorts and surveillance agencies, we constructed a standardized, 4-stage continuum of HIV care for 11 European Union countries for 2013. Stages were defined as (1) number of people living with HIV in the country by end of 2013; (2) proportion of stage 1 ever diagnosed; (3) proportion of stage 2 that ever initiated ART; and (4) proportion of stage 3 who became virally suppressed (= 90% for all stages, and more than half had reached >= 90% for at least 1 stage.Conclusions. European Union countries are nearing the 90-90-90 target. Reducing the proportion undiagnosed remains the greatest barrier to achieving this target, suggesting that further efforts are needed to improve HIV testing rates. Standardizing methods to derive comparable continuums of care remains a challenge.