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艾滋病治疗即预防:动态数学模型的矛盾观点

HIV treatment as prevention: contradictory perspectives from dynamic mathematical models.

作者信息

Wu Jing, Norris Jessie L, Jia Yujiang, Wang Ning

机构信息

National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155 Changbai Road, Beijing 102206, China ; School of Agroforestry and Medicine, The Open University of China, Beijing 100039, China.

National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155 Changbai Road, Beijing 102206, China.

出版信息

ScientificWorldJournal. 2014;2014:760734. doi: 10.1155/2014/760734. Epub 2014 Dec 15.

Abstract

The preventative effects of antiretroviral therapy for people with HIV have been debated since they were first raised. Models commenced studying the preventive effects of treatment in the 1990s, prior to initial public reports. However, the outcomes of the preventive effects of antiretroviral use were not consistent. Some outcomes of dynamic models were based on unfeasible assumptions, such as no consideration of drug resistance, behavior disinhibition, or economic inputs in poor countries, and unrealistic input variables, for example, overstated initiation time, adherence, coverage, and efficacy of treatment. This paper reviewed dynamic mathematical models to ascertain the complex effects of ART on HIV transmission. This review discusses more conservative inputs and outcomes relative to antiretroviral use in HIV infections in dynamic mathematical models. ART alone cannot eliminate HIV transmission.

摘要

自抗逆转录病毒疗法对艾滋病毒感染者的预防作用首次被提出以来,一直存在争议。在最初的公开报告之前,20世纪90年代就开始有模型研究治疗的预防效果。然而,抗逆转录病毒药物使用的预防效果结果并不一致。一些动态模型的结果基于不可行的假设,比如没有考虑耐药性、行为抑制或贫穷国家的经济投入,以及不现实的输入变量,例如夸大了治疗的开始时间、依从性、覆盖率和疗效。本文回顾了动态数学模型,以确定抗逆转录病毒疗法对艾滋病毒传播的复杂影响。本综述讨论了动态数学模型中与艾滋病毒感染中抗逆转录病毒药物使用相关的更保守的输入和结果。仅靠抗逆转录病毒疗法无法消除艾滋病毒传播。

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