Effect of Universal Testing and Treatment on HIV Incidence - HPTN 071 (PopART)
Effect of Universal Testing and Treatment on HIV Incidence - HPTN 071 (PopART)
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DOI：
10.1056/nejmoa1814556
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发表时间：
2019-07-18
影响因子：
158.5
通讯作者：
Fidler, Sarah
中科院分区：
文献类型：
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作者：
Hayes, Richard J.;Donnell, Deborah;Fidler, Sarah
背景普遍的检测和治疗策略是降低人类免疫缺陷病毒（HIV）感染发生率的潜在方法，但以前的试验结果不一致。在2013年至2018年进行的HPTN 071（PopART）社区随机试验中，我们随机分配了赞比亚和南非的21个社区（总人口约100万）改为A组（预防干预与普遍抗逆转录病毒疗法[ART]的联合），B组（根据当地指南提供的ART预防干预[自2016年起普及]）或C组（标准护理）。预防干预措施包括社区工作人员提供的家庭艾滋病毒检测，他们还支持将艾滋病毒护理和抗逆转录病毒疗法坚持联系起来。在每个社区随机抽样的约2000名成年人（18至44岁）的人群队列中测量了主要结局，即12至36个月的艾滋病毒发病率。病毒抑制（
Background A universal testing and treatment strategy is a potential approach to reduce the incidence of human immunodeficiency virus (HIV) infection, yet previous trial results are inconsistent. Methods In the HPTN 071 (PopART) community-randomized trial conducted from 2013 through 2018, we randomly assigned 21 communities in Zambia and South Africa (total population, approximately 1 million) to group A (combination prevention intervention with universal antiretroviral therapy [ART]), group B (the prevention intervention with ART provided according to local guidelines [universal since 2016]), or group C (standard care). The prevention intervention included home-based HIV testing delivered by community workers, who also supported linkage to HIV care and ART adherence. The primary outcome, HIV incidence between months 12 and 36, was measured in a population cohort of approximately 2000 randomly sampled adults (18 to 44 years of age) per community. Viral suppression (