Colebunders Robert, Moses Kamya R, Laurence John, Shihab Hasan M, Semitala Fred, Lutwama Fred, Bakeera-Kitaka Sabrina, Lynen Lut, Spacek Lisa, Reynolds Steven J, Quinn Thomas C, Viner Brant, Mayanja-Kizza Harriet
Infectious Disease Institute, Faculty of Medicine, Makerere University, Kampala, Uganda.
Lancet Infect Dis. 2006 Jan;6(1):53-9. doi: 10.1016/S1473-3099(05)70327-3.
Monitoring the efficacy of antiretroviral treatment in developing countries is difficult because these countries have few laboratory facilities to test viral load and drug resistance. Those that exist are faced with a shortage of trained staff, unreliable electricity supply, and costly reagents. Not only that, but most HIV patients in resource-poor countries do not have access to such testing. We propose a new model for monitoring antiretroviral treatment in resource-limited settings that uses patients' clinical and treatment history, adherence to treatment, and laboratory indices such as haemoglobin level and total lymphocyte count to identify virological treatment failure, and offers patients future treatment options. We believe that this model can make an accurate diagnosis of treatment failure in most patients. However, operational research is needed to assess whether this strategy works in practice.
在发展中国家监测抗逆转录病毒治疗的疗效很困难，因为这些国家几乎没有检测病毒载量和耐药性的实验室设施。现有的实验室面临着训练有素的工作人员短缺、电力供应不稳定以及试剂成本高昂的问题。不仅如此，资源匮乏国家的大多数艾滋病毒患者无法获得此类检测。我们提出了一种在资源有限环境中监测抗逆转录病毒治疗的新模式，该模式利用患者的临床和治疗史、对治疗的依从性以及血红蛋白水平和总淋巴细胞计数等实验室指标来识别病毒学治疗失败情况，并为患者提供未来的治疗选择。我们相信这种模式能够对大多数患者的治疗失败做出准确诊断。然而，需要进行运筹学研究来评估这一策略在实际中是否可行。
