Mitty Jennifer Adelson, Stone Valerie E, Sands Michael, Macalino Grace, Flanigan Timothy
Division of Infectious Diseases, The Miriam Hospital, Providence, RI, 02906, USA.
Clin Infect Dis. 2002 Apr 1;34(7):984-90. doi: 10.1086/339447. Epub 2002 Feb 27.
The principle of directly observed therapy (DOT) has its roots in the treatment of tuberculosis (TB), for which DOT programs have improved cure rates in hard-to-reach populations. Human immunodeficiency virus (HIV) and TB affect similar populations, and there are concerns about both regarding the development of drug resistance associated with poor adherence to therapy. Accordingly, DOT may benefit certain HIV-infected people who have difficulty adhering to highly active antiretroviral therapy. However, important differences exist in the treatment of these diseases that raise questions about how DOT can be adapted to HIV therapy. DOT for management of HIV infection has been effective among prisoners and in pilot programs in Haiti, Rhode Island, and Florida. Although DOT can successfully treat HIV infection in marginalized populations in the short term, a multitude of questions remain. This review provides an account of the preliminary development of DOT programs for the treatment of HIV-infected individuals.
直接观察治疗（DOT）原则起源于结核病（TB）治疗，DOT项目提高了难以接触人群的治愈率。人类免疫缺陷病毒（HIV）和结核病影响相似人群，人们担心这两种疾病都存在因治疗依从性差而产生耐药性的问题。因此，DOT可能使某些难以坚持高效抗逆转录病毒治疗的HIV感染者受益。然而，这些疾病的治疗存在重要差异，这引发了关于如何使DOT适用于HIV治疗的问题。在囚犯以及海地、罗德岛和佛罗里达州的试点项目中，用于管理HIV感染的DOT已取得成效。虽然DOT能在短期内成功治疗边缘化人群的HIV感染，但仍存在诸多问题。本综述介绍了用于治疗HIV感染者的DOT项目的初步发展情况。
