Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892, USA.
Clin Infect Dis. 2010 Sep 15;51(6):725-31. doi: 10.1086/655889.
Research on the prevention of human immunodeficiency virus (HIV)-1 infection is at a critical juncture. Major methodological challenges to performing prevention trials have emerged, and one after another promising biomedical interventions have failed to reduce the incidence of HIV-1 infection. Nevertheless, there is growing optimism that progress can be achieved in the near term. Mathematical modeling indicates that 2 new strategies, "test and treat" and preexposure prophylaxis, could have a major impact on the incidence of HIV-1 infection. Will our hopes be justified? We review the potential strengths and limitations of these antiretroviral "treatment as prevention" strategies and outline other new options for reducing the incidence of HIV-1 infection in the near term. By maximizing the potential of existing interventions, developing other effective strategies, and combining them in an optimal manner, we have the opportunity to bring the HIV-1 epidemic under control.
预防人类免疫缺陷病毒 (HIV)-1 感染的研究正处于关键阶段。进行预防试验面临着重大的方法学挑战，一个又一个有前途的生物医学干预措施未能降低 HIV-1 感染的发生率。尽管如此，人们越来越乐观地认为，近期内可能会取得进展。数学模型表明，“检测和治疗”以及暴露前预防这 2 种新策略可能会对 HIV-1 感染的发生率产生重大影响。我们的期望会得到证实吗？我们回顾了这些抗逆转录病毒“治疗即预防”策略的潜在优势和局限性，并概述了其他近期内降低 HIV-1 感染发生率的新选择。通过最大限度地发挥现有干预措施的潜力、开发其他有效的策略并以最佳方式将它们结合起来，我们有机会控制 HIV-1 流行。
