Vita-Salute San Raffaele University, via Stamira D'Ancona 20, 20127, Milan, Italy.
U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, USA.
AIDS Res Ther. 2019 Sep 6;16(1):25. doi: 10.1186/s12981-019-0240-4.
Thailand has the highest prevalence of HIV among countries in Asia but has also been a pioneer in HIV prevention and treatment efforts in the region, reducing the incidence of new infections significantly over the last two decades. Building upon this remarkable history, Thailand has set an ambitious goal to stop the AIDS epidemic in the country by 2030. A key component of the strategy to achieve this goal includes scale-up of HIV screening programs to facilitate early HIV diagnosis and investment in mechanisms to support immediate initiation of antiretroviral therapy (ART). Initiation of ART during early or acute HIV infection not only reduces viremia, thereby halting onward transmission of HIV, but also may facilitate HIV remission by reducing the size of the latent HIV reservoir and preserving immune function. In Thailand, many efforts have been made to reduce the time from HIV infection to diagnosis and from diagnosis to treatment, especially among men who have sex with men and transgender women. Successfully identifying and initiating ART in individuals with acute HIV infection has been leveraged to conduct groundbreaking studies of novel strategies to achieve HIV remission, including studies of broadly-neutralizing HIV-specific monoclonal antibodies and candidate therapeutic vaccines. These efforts have mostly been deployed in Bangkok and future efforts should include other urban and more rural areas. Continued progress in HIV prevention, screening, and treatment will position Thailand to substantially limit new infections and may pave the way for an HIV cure.
泰国是亚洲艾滋病毒感染率最高的国家，但也是该地区艾滋病毒预防和治疗工作的先驱，在过去二十年中，新感染病例的发病率显著下降。在这一显著成就的基础上，泰国设定了一个雄心勃勃的目标，即在 2030 年之前在全国范围内控制艾滋病疫情。实现这一目标的战略的一个关键组成部分包括扩大艾滋病毒筛查方案，以促进早期艾滋病毒诊断，并投资于支持立即开始抗逆转录病毒治疗（ART）的机制。在艾滋病毒感染的早期或急性期开始接受 ART 治疗，不仅可以降低病毒载量，从而阻止艾滋病毒的继续传播，还可以通过减少潜伏性艾滋病毒储存库的大小和维持免疫功能，促进艾滋病毒缓解。在泰国，已经做出了许多努力来减少从艾滋病毒感染到诊断以及从诊断到治疗的时间，尤其是在男男性行为者和跨性别女性中。成功地识别和启动急性艾滋病毒感染者的 ART 治疗，为探索实现艾滋病毒缓解的新策略提供了机会，包括广泛中和性 HIV 特异性单克隆抗体和候选治疗性疫苗的研究。这些努力主要在曼谷开展，未来的工作应该包括其他城市和更多的农村地区。在艾滋病毒预防、筛查和治疗方面的持续进展将使泰国能够显著限制新的感染，并为实现艾滋病毒治愈铺平道路。
