Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, Mailstop E-45, Atlanta, GA 30333, USA.
Curr Infect Dis Rep. 2009 Jan;11(1):75-83. doi: 10.1007/s11908-009-0011-9.
The HIV epidemic in the United States continues to affect racial/ethnic minorities disproportionately and is increasing among men who have sex with men. Late HIV diagnosis remains common. To reduce HIV transmission and facilitate early linkage to care and antiretroviral treatment, the Centers for Disease Control and Prevention recommends universal voluntary HIV screening for all persons ages 13 to 64 years in public and private care settings. Recent studies demonstrate dramatic reductions in morbidity and mortality with widespread use of highly active combination antiretroviral therapy (cART), and some document improved outcomes when cART is initiated with CD4 cell count >/= 350 cells/mm(3). As patients live longer, they are increasingly affected by chronic diseases, notably cardiovascular and renal disease, diabetes, and non-AIDS-defining cancers. Providers should ensure patients undertake preventive lifestyle changes (eg, smoking cessation, exercise, weight loss, dietary modification) and undergo recommended screening tests to reduce their risk for these important comorbidities.
美国的艾滋病毒疫情继续不成比例地影响着少数族裔/族裔群体，并且在男男性行为者中有所增加。晚期艾滋病毒诊断仍然很常见。为了减少艾滋病毒传播，并促进及早联系护理和抗逆转录病毒治疗，疾病控制和预防中心建议在公共和私人护理环境中对所有 13 至 64 岁的人进行普遍自愿的艾滋病毒筛查。最近的研究表明，广泛使用高效抗逆转录病毒联合疗法（cART）可显著降低发病率和死亡率，并且一些研究证明当 cART 以 CD4 细胞计数> = 350 个细胞/mm（3）启动时，可改善结果。随着患者寿命的延长，他们越来越受到慢性疾病的影响，尤其是心血管和肾脏疾病、糖尿病和非艾滋病定义的癌症。提供者应确保患者进行预防性的生活方式改变（例如戒烟、运动、减肥、饮食调整），并进行建议的筛查测试，以降低这些重要合并症的风险。
