The Impact of Treatment as Prevention on the HIV Epidemic in British Columbia, Canada.
The Impact of Treatment as Prevention on the HIV Epidemic in British Columbia, Canada.
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DOI：
10.1007/s11904-020-00482-6
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发表时间：
2020-04
影响因子：
4.6
通讯作者：
STOP HIV/AIDS Study Group
中科院分区：
文献类型：
--
作者：
Lima VD;Brumme ZL;Brumme C;Sereda P;Krajden M;Wong J;Guillemi SA;Henry B;Hogg RS;Barrios R;Montaner JSG;STOP HIV/AIDS Study Group
本研究拟描述加拿大不列颠哥伦比亚省公共资助的治疗即预防（TasP）战略在减少艾滋病毒/艾滋病流行对个人和公众健康的影响方面的影响。在不列颠哥伦比亚省，TasP与艾滋病毒相关发病率和死亡率的稳步下降有关。与此同时，在艾滋病毒感染者（PLWH）中观察到人口结构的转变，大多数接受抗逆转录病毒治疗（ART）的人现在年龄≥50岁，至少患有一种合并症，并死于与年龄相关的合并症。我们还记录了ART扩展导致病毒载量抑制比例的逐渐增加。虽然近年来抗逆转录病毒治疗前的CD4 T细胞计数稳步增加，但仍有很大比例的艾滋病病毒感染者在艾滋病毒感染的后期被诊断出来。新的艾滋病毒诊断率正在迅速下降，但在男男性行为者（MSM）中下降的程度较小，而BC省目前在这一人群中传染性梅毒病例正在增加。这些事实加强了TasP在减少艾滋病毒传播方面的有效性，但同时也突出了需要进一步创新，以加强对MSM中艾滋病毒和梅毒的控制。这项研究支持开发新方法，以解决不列颠哥伦比亚省TasP战略中的现有差距，以及PLWH未来的卫生需求。
This study proposes to describe the impact of a publicly funded Treatment as Prevention (TasP) strategy in British Columbia (BC), Canada, in decreasing the individual and public health impact of the HIV/AIDS Epidemic. In BC, TasP has been associated with a steady decline in HIV-related morbidity and mortality. At the same time, a demographic transition was observed among people living with HIV (PLWH), with the majority of those on antiretroviral treatment (ART) now ≥50 years of age, living with at least one comorbidity, and dying from age-associated comorbidities. We also documented a progressive increase in the proportion of viral load suppression as a result of ART expansion. While the pre-ART CD4 T cell count has increased steadily in recent years, there is still a large proportion of PLWH being diagnosed in later stages of HIV infection. New HIV diagnoses have been rapidly declining, however to a lesser extent among men who have sex with men (MSM), and BC is currently experiencing an increase in infectious syphilis cases in this population. These facts reinforce the effectiveness of TasP in decreasing HIV transmission, but at the same time, it highlights the need for further innovation to enhance the control of HIV and syphilis among MSM. This study supports the development of new approaches that address existing gaps in the TasP strategy in BC, and the future health needs of PLWH.
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120.7
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