Brown Alison E, Nardone Anthony, Delpech Valerie C
HIV/STI Department, Centre for Infectious Disease Surveillance and Control, Health Protection Directorate, Public Health England, London, UK.
AIDS. 2014 Jan 14;28(2):281-3. doi: 10.1097/QAD.0000000000000137.
The WHO guidelines recommend antiretroviral therapy (ART) begins when CD4 cell counts reach less than 500 cells to reduce HIV transmission. In the UK, 96 000 people were living with HIV (PLWHIV) in 2011, ART coverage was 84% among the diagnosed population and 42% of PLWHIV had detectable viraemia. Using published methods, we estimate starting ART at below 500 CD4 cells could have reduced the proportion of PLWHIV with detectable viraemia from 42% to 38%, whereas halving the undiagnosed population could have led to a decrease to 28%. In the UK, it is unlikely early treatment will reduce HIV transmission unless the undiagnosed population is substantially reduced.
世界卫生组织的指南建议，当CD4细胞计数降至低于500个细胞时开始抗逆转录病毒疗法（ART），以减少艾滋病毒传播。2011年，英国有9.6万人感染艾滋病毒（PLWHIV），确诊人群中的ART覆盖率为84%，42%的PLWHIV有可检测到的病毒血症。使用已发表的方法，我们估计在CD4细胞低于500时开始ART可能会使有可检测到病毒血症的PLWHIV比例从42%降至38%，而将未确诊人群减半可能会使其降至28%。在英国，除非大幅减少未确诊人群，否则早期治疗不太可能减少艾滋病毒传播。
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