Traversing the cascade: urgent research priorities for implementing the ‘treat all’ strategy for children and adolescents living with HIV in sub-Saharan Africa
Traversing the cascade: urgent research priorities for implementing the ‘treat all’ strategy for children and adolescents living with HIV in sub-Saharan Africa
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穿越级联：为撒哈拉以南非洲地区感染艾滋病毒的儿童和青少年实施“治疗所有人”战略的紧急研究重点
DOI：
10.1016/s2055-6640(20)30344-7
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发表时间：
2018
影响因子：
5.5
通讯作者：
R. Vreeman
中科院分区：
文献类型：
--
作者：
L. Enane;M. Davies;V. Leroy;A. Edmonds;E. Apondi;A. Adedimeji;R. Vreeman
撒哈拉以南非洲感染艾滋病毒（CALHIV）的儿童和青少年发病率高，死亡率高得惊人，原因是艾滋病毒护理级联存在严重差距，包括诊断和开始治疗较晚，以及护理和坚持治疗的情况较差。加强成人艾滋病毒护理级联的干预措施可能无法有效地改善CALHIV的级联，因此需要具体的策略。需要特别注意撒哈拉以南非洲的情况，世界上85%以上的艾滋病毒感染者生活在那里。在撒哈拉以南非洲实施“治疗所有人”战略需要作出专门的努力，以解决艾滋病毒的独特诊断和护理需求，从而改善儿科和青少年的结果，预防病毒耐药性并减少新的艾滋病毒感染人数。我们从婴儿、儿童和青少年的角度考虑了联合国艾滋病规划署90-90-90目标，并讨论了在撒哈拉以南非洲实施“治疗所有人”战略时艾滋病毒感染的关键挑战、知识差距和紧迫的研究重点。
Children and adolescents living with HIV (CALHIV) in sub-Saharan Africa experience significant morbidity and alarmingly high mortality rates due to critical gaps in the HIV care cascade, including late diagnosis and initiation of treatment, as well as poor retention in care and adherence to treatment. Interventions to strengthen the adult HIV care cascade may not be as effective in improving the cascade for CALHIV, for whom specific strategies are needed. Particular attention needs to be paid to the contexts of sub-Saharan Africa, where more than 85% of the world's CALHIV live. Implementing the ‘treat all’ strategy in sub-Saharan Africa requires dedicated efforts to address the unique diagnosis and care needs of CALHIV, in order to improve paediatric and adolescent outcomes, prevent viral resistance and reduce the number of new HIV infections. We consider the UNAIDS 90-90-90 targets from the perspective of infants, children and adolescents, and discuss the key challenges, knowledge gaps and urgent research priorities for CALHIV in implementation of the ‘treat all’ strategy in sub-Saharan Africa.
影响因子：
56.3
作者：
Lowenthal, Elizabeth D.;Bakeera-Kitaka, Sabrina;Marukutira, Taftreyi;Chapman, Jennifer;Goldrath, Kathryn;Ferrand, Rashida A.
通讯作者：
Ferrand, Rashida A.
DOI：
10.1056/nejmoa0800971
发表时间：
2008-11-20
期刊：
The New England journal of medicine
影响因子：
--
作者：
Violari A;Cotton MF;Gibb DM;Babiker AG;Steyn J;Madhi SA;Jean-Philippe P;McIntyre JA;CHER Study Team
通讯作者：
CHER Study Team