Office of HIV/AIDS Policy, U.S. Department of Health and Human Services, Washington DC, USA.
Curr Opin HIV AIDS. 2012 Mar;7(2):111-6. doi: 10.1097/COH.0b013e32834fcff6.
This review explores the policy implications of findings from the HIV Prevention Trials Network (HPTN 052) treatment as prevention (TasP) study.
To date, the potential of antiretrovirals to prevent sexual transmission of HIV by infected persons has been grounded in observational cohort, ecological, mathematical modeling, and meta-analytic studies. HPTN 052 represents the first randomized controlled trial to test the secondary prevention benefit of HIV transmission using antiretroviral treatment in largely asymptomatic persons with high CD4 cell counts.
The US National HIV/AIDS Strategy has among its key goals the reduction of incident HIV infections, improved access to quality care and associated outcomes, and the reduction in HIV-associated health disparities and inequities. HPTN 052 demonstrates that providing TasP, in combination with other effective prevention strategies offers the promise of achieving these life-saving goals. But HPTN 052 also highlights the need for cautious optimism and underscores the importance of addressing current gaps in the HIV prevention, treatment, and care continuum in order for 'TasP' strategies to achieve their full potential. Among these are necessary improvements in the capacity to expand HIV testing, facilitate effective linkage and retention in care, and improve treatment initiation, maintenance, and virus suppression.
目的综述：本综述探讨了艾滋病预防试验网络（HPTN 052）治疗即预防（TasP）研究结果的政策意义。
最新发现：迄今为止，抗逆转录病毒通过感染个体预防 HIV 性传播的潜力已经在观察性队列、生态学、数学建模和荟萃分析研究中得到证实。HPTN 052 代表了第一个使用抗逆转录病毒治疗在高 CD4 细胞计数的大量无症状感染者中测试 HIV 传播二级预防益处的随机对照试验。
总结：美国国家艾滋病战略的主要目标包括减少新的 HIV 感染，改善获得优质护理和相关结果的机会，以及减少与 HIV 相关的健康差距和不平等。HPTN 052 表明，提供 TasP，结合其他有效的预防策略，有望实现这些拯救生命的目标。但 HPTN 052 也突显了谨慎乐观的必要性，并强调了必须解决 HIV 预防、治疗和护理连续体中当前的差距，以使“TasP”策略充分发挥潜力。其中包括必要的改进，以扩大 HIV 检测，促进有效的关联和保持在护理中，并改善治疗的启动、维持和病毒抑制。
