Predicting the long-term impact of antiretroviral therapy scale-up on population incidence of tuberculosis.
Predicting the long-term impact of antiretroviral therapy scale-up on population incidence of tuberculosis.
复制标题
DOI：
10.1371/journal.pone.0075466
复制
发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
White RG
中科院分区：
文献类型：
--
作者：
Dodd PJ;Knight GM;Lawn SD;Corbett EL;White RG
研究抗逆转录病毒治疗（ART）对撒哈拉以南非洲长期人群水平结核病（TB）发病率的影响。我们使用一个数学模型来考虑在不同的情况下，对人口艾滋病发病率和抗逆转录病毒治疗覆盖率的趋势，在长期抗逆转录病毒治疗期间的预期寿命和结核病风险的不同假设的影响。我们探讨的所有情景都预测，广泛采用抗逆转录病毒疗法最初会降低人口水平的结核病发病率。然而，许多模拟情景预测，大约20年后，人口水平的结核病发病率会反弹。如果同一时期艾滋病毒发病率的下降不够迅速，或者如果抗逆转录病毒疗法对结核病的保护作用不能持续，预计这种反弹将超过抗逆转录病毒疗法扩大之前的结核病发病率。尽管如此，大多数情况下预测的累计结核病发病率下降时，伴随着艾滋病毒发病率的相对下降超过10%，每年。尽管在撒哈拉以南非洲扩大抗逆转录病毒疗法对人口结核病发病率有短期益处，但长期预测增加了结核病发病率反弹的可能性。这突出了维持对抗逆转录病毒疗法的良好依从性和免疫反应的重要性，以及至关重要的是，需要有效的艾滋病毒预防干预措施，包括早日广泛实施抗逆转录病毒疗法。
To investigate the impact of antiretroviral therapy (ART) on long-term population-level tuberculosis disease (TB) incidence in sub-Saharan Africa. We used a mathematical model to consider the effect of different assumptions about life expectancy and TB risk during long-term ART under alternative scenarios for trends in population HIV incidence and ART coverage. All the scenarios we explored predicted that the widespread introduction of ART would initially reduce population-level TB incidence. However, many modelled scenarios projected a rebound in population-level TB incidence after around 20 years. This rebound was predicted to exceed the TB incidence present before ART scale-up if decreases in HIV incidence during the same period were not sufficiently rapid or if the protective effect of ART on TB was not sustained. Nevertheless, most scenarios predicted a reduction in the cumulative TB incidence when accompanied by a relative decline in HIV incidence of more than 10% each year. Despite short-term benefits of ART scale-up on population TB incidence in sub-Saharan Africa, longer-term projections raise the possibility of a rebound in TB incidence. This highlights the importance of sustaining good adherence and immunologic response to ART and, crucially, the need for effective HIV preventive interventions, including early widespread implementation of ART.
登录
查看更多内容
DOI：
10.1073/pnas.1005660107
发表时间：
2010-11-09
影响因子：
11.1
作者：
Williams, Brian G.;Granich, Reuben;Dye, Christopher
通讯作者：
Dye, Christopher
影响因子：
168.9
作者：
Babiker, A;Darby, S;Schechter, M
通讯作者：
Schechter, M
影响因子：
168.9
作者：
Harries, Anthony D.;Zachariah, Rony;De Cock, Kevin M.
通讯作者：
De Cock, Kevin M.
DOI：
10.5588/ijtld.10.0483
发表时间：
2011-05
期刊：
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
影响因子：
--
作者：
Lawn SD;Harries AD;Williams BG;Chaisson RE;Losina E;De Cock KM;Wood R
通讯作者：
Wood R
影响因子：
168.9
作者：
Samandari, Taraz;Agizew, Tefera B.;Wells, Charles D.
通讯作者：
Wells, Charles D.