Antiretroviral therapy initiated soon after HIV diagnosis as standard care: potential to save lives?
Antiretroviral therapy initiated soon after HIV diagnosis as standard care: potential to save lives?
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HIV 诊断后立即开始抗逆转录病毒治疗作为标准治疗：有可能挽救生命吗？
DOI：
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
Brett Williams
中科院分区：
文献类型：
--
作者：
;Robertson;J. Hargrove;Brett Williams
：2008 年，估计有 3340 万人感染了人类免疫缺陷病毒 (HIV)，约 400 万人正在接受抗逆转录病毒治疗 (ART)。然而，2007年，根据世界卫生组织目前的指导方针，估计有670万人需要抗逆转录病毒治疗，另有270万人感染了艾滋病毒。大多数目前不符合抗逆转录病毒疗法资格的人将在未来十年内获得资格，从而使当前的治疗策略不可持续。过去十年中，更便宜、毒性更小、更有效的抗逆转录病毒药物的开发使得人们有可能考虑遏制艾滋病毒/艾滋病流行的新策略。越来越多的证据表明，抗逆转录病毒治疗可用于预防艾滋病毒传播，而且早期开始治疗对艾滋病毒感染者有益。数学模型预测，通过每年对整个社区进行检测并立即治疗所有感染者，在未来 40 年内可以避免多达 720 万与艾滋病相关的死亡，可以减少抗击艾滋病毒流行所需的长期资金，最重要的是，可以在全面实施该战略的 1-2 年内重新控制艾滋病毒/艾滋病流行。我们讨论了预防艾滋病毒传播的 ART 概念的发展，以及测试和治疗策略可能对艾滋病毒流行产生的模拟影响，因此认为应该进行现场试验来确认模型参数，突出任何实际问题，并测试模型的预测。
: In 2008, an estimated 33.4 million people were infected with human immunodeficiency virus (HIV) and ∼ 4 million people were receiving antiretroviral therapy (ART). However, in 2007, an estimated 6.7 million people were in need of ART under the current World Health Organization guidelines, and 2.7 million more people became infected with HIV. Most of those not currently eligible for ART will become eligible within the next decade, making the current treatment strategy unsustainable. The development of cheaper, less toxic, and more potent antiretrovirals over the past decade has made it possible to consider novel strategies of arresting the HIV/AIDS epidemic. Evidence is growing that ART can be used to prevent HIV transmission and that earlier initiation of treatment is beneficial for those infected with HIV. A mathematical model predicts that by testing whole communities annually and treating all who are infected immediately, up to 7.2 million AIDS-related deaths could be prevented in the next 40 years, long-term funding required to fight the HIV epidemic could be reduced, and, most importantly, control of the HIV/ AIDS epidemic could be regained within 1–2 years of full-scale implementation of the strategy. We discuss the development of the concept of ART for the prevention of HIV transmission and the modeled impact that a test-and-treat strategy could have on the HIV epidemic, and consequently argue that a field trial should be carried out to confirm model parameters, highlight any practical problems, and test the model’s predictions.
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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：
158.5
作者：
Quinn, TC;Wawer, MJ;Gray, RH
通讯作者：
Gray, RH
母体血浆人类免疫缺陷病毒 1 型 RNA 水平：母婴传播的决定因素和预计阈值。
DOI：
10.1073/pnas.92.26.12100
发表时间：
1995
影响因子：
11.1
作者：
Fang,G;Burger,H;Grimson,R;Tropper,P;Nachman,S;Mayers,D;Weislow,O;Moore,R;Reyelt,C;Hutcheon,N;Baker,D;Weiser,B
通讯作者：
Weiser,B
DOI：
10.1056/nejmoa0800971
发表时间：
2008-11-20
期刊：
The New England journal of medicine
影响因子：
--
作者：
Violari A;Cotton MF;Gibb DM;Babiker AG;Steyn J;Madhi SA;Jean-Philippe P;McIntyre JA;CHER Study Team
通讯作者：
CHER Study Team