CD4 Cell Count: Declining Value for Antiretroviral Therapy Eligibility.
CD4 Cell Count: Declining Value for Antiretroviral Therapy Eligibility.
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CD4 细胞计数：抗逆转录病毒治疗资格价值下降。
DOI：
10.1093/cid/civ1224
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Williams,BrianG
中科院分区：
文献类型：
--
作者：
Ying,Roger;Granich,ReubenM;Gupta,Somya;Williams,BrianG
针对人类免疫缺陷病毒（HIV）感染者的抗逆转录病毒治疗（ART）政策历来是基于临床适应症，如机会性感染和CD4细胞计数。研究表明，艾滋病毒感染早期的CD4计数不能预测相关的公共卫生结果，如艾滋病毒感染者的疾病进展、死亡率和艾滋病毒传播。CD4计数在个体和人群中也有很大差异，导致测量不精确和任意开始抗逆转录病毒治疗。为了获得治疗的临床和预防益处，目前全球艾滋病毒应对工作的重点是提高艾滋病毒诊断和抗逆转录病毒治疗的覆盖率。当药物昂贵且有严重副作用时，以及早期开始抗逆转录病毒治疗的影响尚不清楚时，开始抗逆转录病毒治疗的CD4计数是必要的。然而，目前的证据表明，尽管CD4计数可能仍然在指导临床护理开始预防机会性感染方面发挥作用，但开始抗逆转录病毒治疗时应不再需要CD4计数。
Antiretroviral therapy (ART) policy for people living with human immunodeficiency virus (HIV) has historically been based on clinical indications, such as opportunistic infections and CD4 cell counts. Studies suggest that CD4 counts early in HIV infection do not predict relevant public health outcomes such as disease progression, mortality, and HIV transmission in people living with HIV. CD4 counts also vary widely within individuals and among populations, leading to imprecise measurements and arbitrary ART initiation. To capture the clinical and preventive benefits of treatment, the global HIV response now focuses on increasing HIV diagnosis and ART coverage. CD4 counts for ART initiation were necessary when medications were expensive and had severe side effects, and when the impact of early ART initiation was unclear. However, current evidence suggests that although CD4 counts may still play a role in guiding clinical care to start prophylaxis for opportunistic infections, CD4 counts should cease to be required for ART initiation.
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影响因子：
56.9
作者：
Blower, SM;Gershengorn, HB;Grant, RM
通讯作者：
Grant, RM
影响因子：
6.4
作者：
Williams, Brian G.;Korenromp, Eline L.;Dye, Christopher
通讯作者：
Dye, Christopher
影响因子：
158.5
作者：
Gulick, RM;Mellors, JW;Chodakewitz, JA
通讯作者：
Chodakewitz, JA
影响因子：
2.7
作者：
Kelly, P;Zulu, I;Farthing, MJG
通讯作者：
Farthing, MJG
DOI：
10.1097/qad.0000000000000012
发表时间：
2013-11-13
期刊：
AIDS (London, England)
影响因子：
--
作者：
Amornkul PN;Karita E;Kamali A;Rida WN;Sanders EJ;Lakhi S;Price MA;Kilembe W;Cormier E;Anzala O;Latka MH;Bekker LG;Allen SA;Gilmour J;Fast PE;IAVI Africa HIV Prevention Partnership
通讯作者：
IAVI Africa HIV Prevention Partnership