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中国免费抗逆转录病毒治疗项目:挑战与应对措施

The Chinese free antiretroviral treatment program: challenges and responses.

作者信息

Zhang Fujie, Haberer Jessica E, Wang Yu, Zhao Yan, Ma Ye, Zhao Decai, Yu Lan, Goosby Eric P

机构信息

National Center for AIDS/STD Control and Prevention/ Chinese Center for Disease Control and Prevention, Beijing, China.

出版信息

AIDS. 2007 Dec;21 Suppl 8:S143-8. doi: 10.1097/01.aids.0000304710.10036.2b.

Abstract

To respond to the HIV/AIDS epidemic in China, the National Center for AIDS/STD Control and Prevention established the Division of Treatment and Care in late 2001. The pilot for the National Free ART Program began in Henan Province in 2002, and the program fully began in 2003. Treatment efforts initially focused on patients infected through illicit blood and plasma donation in the mid-1990s and subsequently expanded to include HIV-infected injection drug users, commercial sex workers, pregnant women, and children. The National Free ART Database was established in late 2004, and includes data on current patients and those treated before 2004. Over 31 000 adult and pediatric patients have been treated thus far. Challenges for the program include integration of drug treatment services with ART, an under-resourced health care system, co-infections, stigma, discrimination, drug resistance, and procurement of second-line ART. The merging of national treatment and care, epidemiologic, and drug resistance databases will be critical for a better understanding of the epidemic, for earlier identification of patients requiring ART, and for improved patient follow-up. The Free ART Program has made considerable progress in providing the necessary care and treatment for HIV-infected people in China and has strong government support for continued improvement and expansion.

摘要

为应对中国的艾滋病毒/艾滋病疫情,国家艾滋病/性病控制与预防中心于2001年末设立了治疗与关怀司。国家免费抗逆转录病毒治疗项目试点于2002年在河南省启动,并于2003年全面开展。治疗工作最初集中于20世纪90年代中期因非法采血和血浆感染的患者,随后扩大到包括感染艾滋病毒的注射吸毒者、商业性工作者、孕妇和儿童。国家免费抗逆转录病毒治疗数据库于2004年末建立,包含现有患者及2004年之前接受治疗患者的数据。迄今为止,已有超过3.1万名成人和儿童患者接受了治疗。该项目面临的挑战包括将药物治疗服务与抗逆转录病毒治疗相结合、卫生保健系统资源不足、合并感染、耻辱感、歧视、耐药性以及二线抗逆转录病毒治疗药物的采购。合并国家治疗与关怀、流行病学和耐药性数据库对于更好地了解疫情、尽早识别需要抗逆转录病毒治疗的患者以及改善患者随访至关重要。免费抗逆转录病毒治疗项目在中国为艾滋病毒感染者提供必要的护理和治疗方面取得了相当大的进展,并得到了政府的大力支持以持续改进和扩大。

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