抗逆转录病毒疗法对 HIV 阳性成年人中年轻女性新发 HIV 感染的影响：系统评价方案。
Effects of antiretroviral therapy in HIV-positive adults on new HIV infections among young women: a systematic review protocol.
机构信息
Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
出版信息
Syst Rev. 2019 Mar 5;8(1):68. doi: 10.1186/s13643-019-0982-z.
BACKGROUND
The HIV/AIDS pandemic has struck regions, countries, and populations in different ways. With the introduction of antiretroviral drugs, people living with HIV (PLHIV) have a much better prognosis, even though there are still many new infections in young women. The role of widespread antiretroviral therapy (ART) on the incidence of HIV in young women is unknown.
METHODS
We will conduct a comprehensive search of MEDLINE (PubMed), Excerpta Medica database (EMBASE), Scopus, Google Scholar, Cochrane Central Register of Controlled Trials (CENTRAL), World Health Organization's (WHO's) library database, Latin American and Caribbean Health Sciences Literature (LILACS), conference abstracts, and gray literature sources to identify any relevant literature. We will include randomized and non-randomized clinical trials and cohort studies in which ART was offered to adults aged 18 and above reporting outcomes in females aged 15 to 24 years. The outcomes of interest are HIV incidence, ART initiation, adherence, retention, and viral load suppression. We will screen titles, abstracts, and the full texts of relevant articles in duplicate. Disagreements will be resolved by consensus. We will extract data on the risk of HIV infection in younger females after the use of ART in the adult population.
DISCUSSION
To our knowledge, this is the first systematic review to look at the impact of ART use among adults on HIV incidence in young women. The results of this review will be used in a modeling study to simulate the effects of using ART as an effective tool to prevent sexual transmission of HIV to young women. Our findings will inform the treatment-as-prevention (TasP) strategy to reduce new HIV infections among young women.
SYSTEMATIC REVIEW REGISTRATION
The systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42018099174 .
背景
艾滋病大流行以不同的方式袭击了不同地区、国家和人群。随着抗逆转录病毒药物的问世，艾滋病毒感染者（PLHIV）的预后要好得多，尽管年轻女性中仍有许多新的感染。广泛应用抗逆转录病毒疗法（ART）对年轻女性中艾滋病毒发病率的影响尚不清楚。
方法
我们将全面检索 MEDLINE（PubMed）、Excerpta Medica 数据库（EMBASE）、Scopus、Google Scholar、Cochrane 中心对照试验注册库（CENTRAL）、世界卫生组织（WHO）图书馆数据库、拉丁美洲和加勒比健康科学文献（LILACS）、会议摘要和灰色文献来源，以确定任何相关文献。我们将纳入提供成人抗逆转录病毒治疗（ART）并报告 15 至 24 岁女性结局的随机和非随机临床试验和队列研究。主要结局为 HIV 发病率、ART 起始、依从性、保留率和病毒载量抑制。我们将重复对标题、摘要和相关文章全文进行筛选。意见分歧将通过协商解决。我们将提取在成年人群中使用 ART 后年轻女性感染 HIV 风险的数据。
讨论
据我们所知，这是首次系统评价评估在成年人群中使用 ART 对年轻女性 HIV 发病率的影响。该系统评价的结果将用于建模研究，以模拟将 ART 作为有效工具用于预防 HIV 通过性途径向年轻女性传播的效果。我们的研究结果将为治疗即预防（TasP）策略提供信息，以减少年轻女性中的新 HIV 感染。
系统评价注册
系统评价方案已在国际前瞻性系统评价登记处（PROSPERO）注册，注册号为 CRD42018099174。
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