Kim Maria H, Ahmed Saeed, Abrams Elaine J
Baylor College of Medicine, Department of Pediatrics, Section of Retrovirology, Houston, Texas, USA ; Baylor College of Medicine-Abbott Fund Children's Clinical Center of Excellence, Lilongwe, Malawi.
ICAP-Columbia University, Mailman School of Public Health, New York NY, USA ; College of Physicians & Surgeons, Columbia University, New York, NY, USA.
Curr Pediatr Rep. 2015 Sep;3(3):219-229. doi: 10.1007/s40124-015-0087-7. Epub 2015 Jul 22.
This review provides an update on current developments with prevention, treatment and cure strategies in the field of pediatric HIV.
RECENT FINDINGS/SUMMARY: There has been tremendous progress in the prevention and treatment of pediatric HIV infection. With new strategies for prevention of mother-to-child transmission, we are growing ever closer towards elimination of pediatric HIV, though challenges with retention of pregnant woman and their HIV-exposed infants remain. Ongoing vigilance regarding the potential hazards of ART exposure to infants continues with no significant alarms yet identified. Though cure has not been achieved, evidence of the impact of early treatment on reducing HIV-1 reservoir size with subsequent prolonged remission has enlivened efforts to rapidly identify and treat HIV-infected newborns. There is an increasing array of treatment options for pediatric patients and reassuring evidence regarding long-term complications of ART. Unfortunately, despite evidence suggesting the benefit of early treatment, timely identification and treatment of children remains a challenge. Better strategies for effective case-finding and engagement in care are urgently needed in addition to an improved understanding of how to retain HIV-positive children and adolescents on treatment. However, further emboldened by recent international commitments and robust global support, the future is hopeful.
本综述介绍了儿科HIV领域预防、治疗和治愈策略的当前进展。
最新发现/总结：儿科HIV感染的预防和治疗取得了巨大进展。随着预防母婴传播的新策略的出现，我们正日益接近消除儿科HIV，尽管在留住孕妇及其HIV暴露婴儿方面仍存在挑战。对于ART暴露于婴儿的潜在危害仍需持续警惕，目前尚未发现重大警报。虽然尚未实现治愈，但早期治疗对减少HIV-1储存库大小及随后延长缓解期的影响的证据，激发了快速识别和治疗HIV感染新生儿的努力。儿科患者的治疗选择越来越多，并且有关于ART长期并发症的可靠证据。不幸的是，尽管有证据表明早期治疗有益，但及时识别和治疗儿童仍然是一项挑战。除了更好地理解如何使HIV阳性儿童和青少年坚持治疗外，迫切需要有效的病例发现和参与护理的更好策略。然而，最近的国际承诺和强大的全球支持进一步鼓舞了信心，未来充满希望。
