MMWR Morb Mortal Wkly Rep. 2020 Apr 3;69(13):366-370. doi: 10.15585/mmwr.mm6913a2.
Human immunodeficiency virus (HIV) infection is a deployment-limiting medical condition for U.S. armed forces in the Department of Defense (DoD) (1). HIV management using contemporary antiretroviral therapy (ART) regimens permits effective suppression of viremia among persons in clinical care. Although service members with HIV infection can remain in military service, treatment outcomes have not been fully described. Data from the Defense Medical Surveillance System (DMSS) were analyzed to estimate ART use and viral suppression among DoD service members with diagnosed HIV infection during January 2012-June 2018 (2). Among 1,050 service members newly diagnosed with HIV infection during January 1, 2012-December 31, 2017, 89.4% received ART within 6 months of HIV diagnosis, 95.4% within 12 months, and 98.7% by the end of the surveillance period on June 30, 2018. Analyses determined that, among 793 persons who initiated ART and remained in military service for ≥1 year, 93.8% received continuous ART, 99.0% achieved viral suppression within 1 year after ART initiation, and 96.8% were virally suppressed at receipt of their last viral load test. The DoD model of HIV care demonstrates that service members with HIV infection who remain in care receive timely ART and can achieve both early and sustained viral suppression.
人类免疫缺陷病毒(HIV)感染是美国国防部(DoD)武装部队的一种部署限制医疗条件(1)。使用当代抗逆转录病毒疗法(ART)方案进行 HIV 管理允许在临床护理中有效抑制病毒血症。尽管感染 HIV 的军人仍可留在军队中,但尚未充分描述其治疗结果。对国防医疗监测系统(DMSS)的数据进行了分析,以估计在 2012 年 1 月至 2018 年 6 月期间被诊断为 HIV 感染的 DoD 军人中使用 ART 和病毒抑制的情况(2)。在 2012 年 1 月 1 日至 2017 年 12 月 31 日期间新诊断出 HIV 感染的 1,050 名军人中,89.4%在 HIV 诊断后 6 个月内接受了 ART,95.4%在 12 个月内接受了 ART,98.7%在 2018 年 6 月 30 日监测期结束时接受了 ART。分析结果表明,在 793 名开始接受 ART 并在军队中服役至少 1 年的军人中,93.8%接受了连续的 ART,99.0%在开始接受 ART 后 1 年内实现了病毒抑制,96.8%在接受最后一次病毒载量检测时病毒得到了抑制。DoD 的 HIV 护理模式表明,留在护理中的 HIV 感染军人可以及时接受 ART,并可以实现早期和持续的病毒抑制。