Coutinho R A
Rijksinstituut voor Volksgezondheid en Milieu, Centrum Infectieziektebestrijding, Bilthoven.
Ned Tijdschr Geneeskd. 2007 Dec 1;151(48):2645-7.
At the time of the first aids cases in 1981 in the United States, no one could have predicted that it would signal the start of a worldwide epidemic. To mark World Aids Day, this journal is devoting a special issue to HIV/AIDS. Erroneously, it seems that in the Netherlands HIV/AIDS is sometimes forgotten. Among men who have sex with men, the HIV incidence is around 1%--a rate that is just as high as that among adults in many African countries. In order to slow down the spread of the virus, there should be more intensive testing for HIV, by, for example, 'opting out'. Developments in the field ofHIV/AIDS outside the Netherlands are also discussed. There is an article on a successful HIV/AIDS treatment project setup by Médicins sans Frontières in the Ukraine. The consequences of the large-scale availability of antiretroviral drugs in developing countries are also examined. Because of these programs increased resistance of the virus to the medication may become a problem. Further, a promising initiative to improve the financing of healthcare systems in Africa is discussed. An effective vaccine for HIV seems far away. Recently, Merck halted the development of an HIV vaccine based on T cell immunity, because the clinical results were disappointing. Waning interest in investing in an HIV vaccine from the pharmaceutical sector means that governments will have to increasingly take on this role. For now strategies for the prevention of HIV must be to continue to stimulate safe sexual behavior, good diagnostic and treatment services for sexually transmitted infections, and more and earlier HIV testing.
1981年美国首次出现艾滋病病例时，没有人能够预测到这将标志着一场全球流行病的开始。为纪念世界艾滋病日，本杂志专门出版了一期关于艾滋病毒/艾滋病的特刊。令人遗憾的是，在荷兰，艾滋病毒/艾滋病似乎有时被遗忘了。在男男性行为者中，艾滋病毒感染率约为1%，这一比率与许多非洲国家成年人中的感染率一样高。为了减缓病毒的传播，应该通过例如“选择退出”等方式，对艾滋病毒进行更密集的检测。还讨论了荷兰以外地区艾滋病毒/艾滋病领域的发展情况。有一篇文章介绍了无国界医生组织在乌克兰设立的一个成功的艾滋病毒/艾滋病治疗项目。还研究了抗逆转录病毒药物在发展中国家大规模供应的后果。由于这些项目，病毒对药物的耐药性增加可能会成为一个问题。此外，还讨论了一项改善非洲医疗保健系统融资的有前景的倡议。一种有效的艾滋病毒疫苗似乎还很遥远。最近，默克公司停止了基于T细胞免疫的艾滋病毒疫苗的研发，因为临床结果令人失望。制药行业对投资艾滋病毒疫苗的兴趣减弱意味着政府将不得不越来越多地承担起这一角色。目前，预防艾滋病毒的策略必须继续鼓励安全性行为、提供良好的性传播感染诊断和治疗服务，以及进行更多、更早的艾滋病毒检测。
