模拟将普遍覆盖的艾滋病毒治疗作为预防措施的实施情况及其对艾滋病毒流行的影响。
Modeling the implementation of universal coverage for HIV treatment as prevention and its impact on the HIV epidemic.
作者信息
Ying Roger, Barnabas Ruanne V, Williams Brian G
机构信息
Department of Global Health, University of Washington, Box 359927, 325 Ninth Avenue, Seattle, WA, 98104, USA,
出版信息
Curr HIV/AIDS Rep. 2014 Dec;11(4):459-67. doi: 10.1007/s11904-014-0232-x.
Abstract
The Joint United Nations Programme on HIV/AIDS (UNAIDS) recently updated its global targets for antiretroviral therapy (ART) coverage for HIV-positive persons under which 90 % of HIV-positive people are tested, 90 % of those are on ART, and 90 % of those achieve viral suppression. Treatment policy is moving toward treating all HIV-infected persons regardless of CD4 cell count-otherwise known as treatment as prevention-in order to realize the full therapeutic and preventive benefits of ART. Mathematical models have played an important role in guiding the development of these policies by projecting long-term health impacts and cost-effectiveness. To guide future policy, new mathematical models must consider the barriers patients face in receiving and taking ART. Here, we describe the HIV care cascade and ART delivery supply chain to examine how mathematical modeling can provide insight into cost-effective strategies for scaling-up ART coverage in sub-Saharan Africa and help achieve universal ART coverage.
摘要
联合国艾滋病规划署（UNAIDS）最近更新了其针对艾滋病毒阳性者抗逆转录病毒疗法（ART）覆盖率的全球目标，即90%的艾滋病毒阳性者接受检测，其中90%接受ART治疗，且这些接受治疗者中有90%实现病毒抑制。治疗政策正朝着治疗所有艾滋病毒感染者的方向发展，无论其CD4细胞计数如何，也就是所谓的治疗即预防，以便充分实现ART的治疗和预防效益。数学模型通过预测长期健康影响和成本效益，在指导这些政策的制定方面发挥了重要作用。为指导未来政策，新的数学模型必须考虑患者在接受和服用ART时面临的障碍。在此，我们描述了艾滋病毒护理流程和ART药物供应供应链，以研究数学建模如何能够深入了解在撒哈拉以南非洲扩大ART覆盖率的具有成本效益的策略，并有助于实现普遍的ART覆盖。
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