Enane Leslie A, Davies Mary-Ann, Leroy Valériane, Edmonds Andrew, Apondi Edith, Adedimeji Adebola, Vreeman Rachel C
Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.
Center for Infectious Disease Epidemiology and Research, University of Cape Town, South Africa.
J Virus Erad. 2018 Nov 15;4(Suppl 2):40-46. doi: 10.1016/S2055-6640(20)30344-7.
Children and adolescents living with HIV (CALHIV) in sub-Saharan Africa experience significant morbidity and alarmingly high mortality rates due to critical gaps in the HIV care cascade, including late diagnosis and initiation of treatment, as well as poor retention in care and adherence to treatment. Interventions to strengthen the adult HIV care cascade may not be as effective in improving the cascade for CALHIV, for whom specific strategies are needed. Particular attention needs to be paid to the contexts of sub-Saharan Africa, where more than 85% of the world's CALHIV live. Implementing the 'treat all' strategy in sub-Saharan Africa requires dedicated efforts to address the unique diagnosis and care needs of CALHIV, in order to improve paediatric and adolescent outcomes, prevent viral resistance and reduce the number of new HIV infections. We consider the UNAIDS 90-90-90 targets from the perspective of infants, children and adolescents, and discuss the key challenges, knowledge gaps and urgent research priorities for CALHIV in implementation of the 'treat all' strategy in sub-Saharan Africa.
撒哈拉以南非洲地区的感染艾滋病毒儿童和青少年（CALHIV）由于艾滋病毒治疗流程中存在重大缺口，包括诊断和治疗启动延迟、治疗留存率低以及治疗依从性差，因而发病率高且死亡率惊人。加强成人艾滋病毒治疗流程的干预措施在改善CALHIV治疗流程方面可能效果不佳，针对CALHIV需要特定策略。需要特别关注撒哈拉以南非洲地区的情况，全球85%以上的CALHIV生活在该地区。在撒哈拉以南非洲实施“全面治疗”策略需要付出专门努力，以满足CALHIV独特的诊断和护理需求，从而改善儿童和青少年的治疗效果、预防病毒耐药性并减少新的艾滋病毒感染病例数。我们从婴儿、儿童和青少年的角度审视联合国艾滋病规划署的90-90-90目标，并讨论在撒哈拉以南非洲实施“全面治疗”策略时CALHIV面临的关键挑战、知识差距和紧迫的研究重点。
