Gupta Somya, Granich Reuben, Hersh Bradley, Lepere Philippe, Samb Badara
Special Initiatives, Joint United Nations Programme on HIV/AIDS (UNAIDS), Geneva, Switzerland
Special Initiatives, Joint United Nations Programme on HIV/AIDS (UNAIDS), Geneva, Switzerland.
J Int Assoc Provid AIDS Care. 2014 Sep-Oct;13(5):397-401. doi: 10.1177/2325957414535976. Epub 2014 Jun 4.
The Joint United Nations Programme on HIV/AIDS (UNAIDS) Treatment 2015 calls for expanded access to HIV care and treatment, including cotrimoxazole preventive therapy (CPT), for prevention of HIV-related morbidity and mortality. We review 115 national guidelines from 92 countries for recommendations on CPT for adults and adolescents and determine the level of consistency with the World Health Organization (WHO) guidelines. Of the 66 countries with recommendations, 5 (8%) countries recommend lifelong CPT for people living with HIV; 19 (29%) countries recommend a CD4 count threshold of ≤350 cells/mm(3) or WHO clinical stages III and IV or II, III, and IV; and 19 (29%) countries recommend a CD4 count threshold of ≤200 cells/mm(3). Of the 48 countries with recommendations on discontinuing CPT, 25 (52%) countries recommend discontinuation of cotrimoxazole when the CD4 count is >200 cells/mm(3). World Health Organization guidelines offer countries flexibility on the use of CPT, and countries are recommending a wide range of CD4 counts and WHO clinical stage criteria for prophylaxis initiation and discontinuation.
联合国艾滋病规划署（UNAIDS）《2015年艾滋病治疗报告》呼吁扩大获得艾滋病护理和治疗的机会，包括使用复方新诺明预防性治疗（CPT），以预防与艾滋病相关的发病和死亡。我们审查了来自92个国家的115份国家指南中关于成人和青少年CPT的建议，并确定其与世界卫生组织（WHO）指南的一致程度。在有相关建议的66个国家中，5个（8%）国家建议对艾滋病病毒感染者进行终身CPT；19个（29%）国家建议当CD4细胞计数≤350个/立方毫米或处于WHO临床分期III期和IV期或II期、III期和IV期时进行CPT；19个（29%）国家建议当CD4细胞计数≤200个/立方毫米时进行CPT。在有关于停止CPT建议的48个国家中，25个（52%）国家建议当CD4细胞计数>200个/立方毫米时停止使用复方新诺明。世界卫生组织指南为各国在CPT的使用上提供了灵活性，各国在开始和停止预防性治疗的CD4细胞计数以及WHO临床分期标准方面给出了广泛的建议。
