SARS-CoV-2 与 HIV:流行病学、治疗以及从 HIV 中吸取的经验教训。

SARS-CoV-2 and HIV: Epidemiology, Treatment, and Lessons Learned from HIV.

机构信息

Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington DC, USA.

出版信息

AIDS Rev. 2020;22(3):133-142. doi: 10.24875/AIDSRev.20000070.

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of COVID-19, was first detected in China in December 2019 and has rapidly spread throughout the world. Globally, the impact of COVID-19 has been severe with more than half a million deaths over 6 months; in contrast, the HIV pandemic has resulted in over 32 million deaths worldwide over 40 years. This paper reviews the current epidemiology of COVID-19, summarizes its relationship to HIV, identifies synergies in our response, and suggests actions that can be taken to curtail the spread of COVID-19 among persons living with HIV (PLWH). Our understanding of the epidemiology, clinical presentation, prevention, and treatment of COVID-19 has evolved rapidly as they did with HIV. Epidemiologically, there are similarities between the two viruses including asymptomatic spread, disproportionate impact on persons of color, need for rapid diagnostic testing, and lack of a cure or vaccine. PLWH do not appear generally to have an increased incidence of COVID-19 infection or a more severe course of disease. Clinical trials to identify potential treatment and prevention options for COVID-19 have included antiretrovirals used to treat HIV that have not been efficacious. Public health responses overlap between the two pandemics including the need for behavior change and containment strategies such as contact tracing. As the SARS-CoV-2 pandemic evolves, the path forward to controlling, preventing, and treating COVID-19 can be informed by lessons learned from HIV as we seek to control the spread of both viral pandemics.

摘要

严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)是 COVID-19 的病原体,于 2019 年 12 月在中国首次被发现,随后迅速在全球范围内传播。在全球范围内,COVID-19 的影响非常严重,在 6 个月内导致超过 50 万人死亡;相比之下,艾滋病毒流行在 40 年内导致了全球超过 3200 万人死亡。本文回顾了 COVID-19 的当前流行病学,总结了其与艾滋病毒的关系,确定了我们应对措施中的协同作用,并提出了可以采取的行动,以遏制 COVID-19 在艾滋病毒感染者(PLWH)中的传播。我们对 COVID-19 的流行病学、临床表现、预防和治疗的理解随着对 HIV 的理解而迅速发展。从流行病学角度来看,这两种病毒有一些相似之处,包括无症状传播、对有色人种的不成比例影响、对快速诊断检测的需求以及缺乏治愈方法或疫苗。PLWH 似乎并没有普遍增加 COVID-19 感染的发生率或更严重的疾病病程。为确定 COVID-19 的潜在治疗和预防选择而进行的临床试验包括用于治疗 HIV 的抗逆转录病毒药物,但这些药物均无效。两种大流行的公共卫生应对措施有很多重叠之处,包括需要改变行为和采取遏制策略,如接触者追踪。随着 SARS-CoV-2 大流行的发展,控制、预防和治疗 COVID-19 的前进道路可以从艾滋病毒中吸取经验教训,因为我们试图控制这两种病毒大流行的传播。

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