Antiretroviral Treatment and HIV Care Unit, Department of HIV/AIDS, World Health Organization, Geneva, Switzerland.
Curr Opin HIV AIDS. 2010 Jul;5(4):298-304. doi: 10.1097/COH.0b013e32833a6c32.
An estimated 33 million people are living with HIV and universal access remains a dream for millions of people. By the end of year 2008, four million people were on treatment; however, over five million needed treatment, and in 2007, there were 2.7 million new infections. Without significant improvement in prevention, we are unlikely to meet universal access targets including the growing demand for highly active antiretroviral treatment (HAART). This review examines HAART as a potential tool for preventing HIV transmission.
We discuss recent scientific evidence regarding the treatment and prevention gap, importance viral load and HIV transmission, HAART and HIV transmission, when to start, HIV counseling and testing, modeling results and next steps.
HAART has considerable treatment and prevention benefits and it needs to be considered as a key element of combination prevention. To explore HAART as an effective prevention strategy, we recommend further evaluation of human rights and ethical considerations, clarification of research priorities and exploration of feasibility and acceptability issues.
据估计,有 3300 万人携带艾滋病毒,数百万人仍然难以获得普遍的治疗机会。到 2008 年底,有 400 万人接受了治疗;然而,仍有超过 500 万人需要治疗,而在 2007 年,有 270 万人新感染了艾滋病。如果在预防方面没有显著改善,我们不太可能实现普遍获得治疗的目标,包括对高效抗逆转录病毒治疗(HAART)日益增长的需求。本综述探讨了 HAART 作为预防 HIV 传播的一种潜在工具。
我们讨论了关于治疗和预防差距、病毒载量和 HIV 传播的重要性、HAART 和 HIV 传播、何时开始、艾滋病病毒咨询和检测、模型结果和下一步措施的最新科学证据。
HAART 具有相当大的治疗和预防益处,因此需要将其视为联合预防的关键要素。为了探索 HAART 作为一种有效的预防策略,我们建议进一步评估人权和伦理问题,明确研究重点,并探讨可行性和可接受性问题。