Keating Patrick, Pharris Anastasia, Leitmeyer Katrin, De Angelis Stefania, Wensing Annemarie, Amato-Gauci Andrew J, Broberg Eeva
Österreichische Agentur für Gesundheit und Ernährungssicherheit (AGES), Vienna, Austria.
European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
Euro Surveill. 2017 Dec;22(49). doi: 10.2807/1560-7917.ES.2017.22.49.17-00269.
IntroductionExpanding access to HIV antiretroviral treatment is expected to decrease HIV incidence and acquired immunodeficiency syndrome (AIDS) mortality. However, this may also result in increased HIV drug resistance (DR). Better monitoring and surveillance of HIV DR is required to inform treatment regimens and maintain the long term effectiveness of antiretroviral drugs. As there is currently no formal European Union (EU)-wide collection of HIV DR data, this study aimed to assess the current HIV molecular surveillance capacity in EU/European Economic Area (EEA) countries in order to inform the planning of HIV DR monitoring at EU level. Thirty EU/EEA countries were invited to participate in a survey on HIV molecular surveillance capacity, which also included laboratory aspects. Among 21 responding countries, 13 reported using HIV sequence data (subtype and/or DR) for surveillance purposes at national level. Of those, nine stated that clinical, epidemiological and sequence data were routinely linked for analysis. : We identified similarities between existing HIV molecular surveillance systems, but also found important challenges including human resources, data ownership and legal issues that would need to be addressed.Information on capacities should allow better planning of the phased introduction of HIV DR surveillance at EU/EEA level.
引言
扩大获得艾滋病毒抗逆转录病毒治疗的机会有望降低艾滋病毒发病率和获得性免疫缺陷综合征（艾滋病）死亡率。然而，这也可能导致艾滋病毒耐药性（DR）增加。需要更好地监测和监督艾滋病毒耐药性，以便为治疗方案提供依据并维持抗逆转录病毒药物的长期有效性。由于目前欧盟（EU）范围内没有正式收集艾滋病毒耐药性数据，本研究旨在评估欧盟/欧洲经济区（EEA）国家目前的艾滋病毒分子监测能力，以便为欧盟层面的艾滋病毒耐药性监测规划提供依据。30个欧盟/欧洲经济区国家受邀参与一项关于艾滋病毒分子监测能力的调查，其中也包括实验室方面。在21个回复国家中，13个国家报告在国家层面将艾滋病毒序列数据（亚型和/或耐药性）用于监测目的。其中，9个国家表示临床、流行病学和序列数据会定期关联进行分析。我们发现了现有艾滋病毒分子监测系统之间的相似之处，但也发现了包括人力资源、数据所有权和法律问题等需要解决的重要挑战。关于能力的信息应有助于更好地规划在欧盟/欧洲经济区层面分阶段引入艾滋病毒耐药性监测。
