Vital Signs: Status of Human Immunodeficiency Virus Testing, Viral Suppression, and HIV Preexposure Prophylaxis - United States, 2013-2018
Vital Signs: Status of Human Immunodeficiency Virus Testing, Viral Suppression, and HIV Preexposure Prophylaxis - United States, 2013-2018
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DOI：
10.15585/mmwr.mm6848e1
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发表时间：
2019-12-06
影响因子：
33.9
通讯作者：
Hall, H. Irene
中科院分区：
文献类型：
--
作者：
Harris, Norma S.;Johnson, Anna Satcher;Hall, H. Irene
背景：美国每年大约出现 38,000 例新的人类免疫缺陷病毒 (HIV) 感染：这些感染是可以预防的。一项拟议的国家倡议《结束艾滋病毒流行：美国计划》纳入了三项战略（诊断、治疗和预防艾滋病毒感染），并寻求利用检测、治疗和暴露前预防 (PrEP) 来到 2030 年将美国新发艾滋病毒感染率减少至少 90%。实现这一目标的目标包括至少 95% 的艾滋病毒感染者得到诊断、95% 的艾滋病毒感染诊断者病毒载量受到抑制、 50% 的 HIV 感染风险较高的人群接受了 PrEP。使用监视、药房。方法：CDC 分析 HIV 监测数据，估计每年新发 HIV 感染人数（2013-2017 年）；估计确诊感染的百分比（2017 年）；并确定确诊的艾滋病毒感染者中病毒载量受到抑制的百分比（2017 年）。 CDC 分析了监测、药房和其他数据来估计 PrEP 覆盖率，以百分比形式报告，计算方式为接受 PrEP 处方的人数除以有 PrEP 指征的估计人数。结果：从 2013 年（38,500 例）到 2017 年（37,500 例），新发 HIV 感染人数保持稳定（p = 0.448）。 2017 年，估计有 85.8% 的感染被确诊。在 42 个辖区报告完整实验室数据的 854,206 名艾滋病毒感染者中，62.7% 的病毒载量受到抑制。估计有 120 万人有使用 PrEP 的指征。 2018 年，18.1% 的人接受了 PrEP。结论：美国需要加快诊断、治疗和预防 HIV 感染的努力，以实现到 2030 年将新发 HIV 感染人数至少减少 90% 的目标。
Background: Approximately 38,000 new human immunodeficiency virus (HIV) infections occur in the United States each year: these infections can he prevented. A proposed national initiative, Ending the HIV Epidemic: A Plan for America, incorporates three strategies (diagnose, treat, and prevent HIV infection) and seeks to leverage testing, treatment, and preexposure prophylaxis (PrEP) to reduce new HIV infections in the United States by at least 90% by 2030. Targets to reach this goal include that at least 95% of persons with HIV receive a diagnosis, 95% of persons with diagnosed HIV infection have a suppressed viral load, and 50% of those at increased risk for acquiring HIV are prescribed PrEP. Using surveillance, pharmacy. and other data, CDC determined the current status of these three initiative strategies.Methods: CDC analyzed HIV surveillance data to estimate annual number of new HIV infections (2013-2017); estimate the percentage of infections that were diagnosed (2017); and determine the percentage of persons with diagnosed HIV infection with viral load suppression (2017). CDC analysed surveillance, pharmacy, and other data to estimate PrEP coverage, reported as a percentage and calculated as the number of persons who were prescribed PrEP divided by the estimated number of persons with indications for PrEP.Results: The number of new HIV infections remained stable from 2013 (38,500) to 2017 (37,500) (p = 0.448). In 2017, an estimated 85.8% of infections were diagnosed. Among 854,206 persons with diagnosed HIV infection in 42 jurisdictions with complete reporting of laboratory data, 62.7% had a suppressed viral load. Among an estimated 1.2 million persons with indications for use of PrEP. 18.1% had been prescribed PrEP in 2018.Conclusion: Accelerated efforts to diagnose, treat, and prevent HIV infection are needed to achieve the U.S. goal of at least 90% reduction in the number of new HIV infections by 2030.