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接受度、动机和治愈前景:关注 HIV 治愈的治疗中断研究中 HIV 感染者及其医护人员的观点。

Acceptability, motivation and the prospect of cure for people living with HIV and their healthcare providers in HIV cure-focused treatment interruption studies.

机构信息

Department of Infectious Diseases, Alfred Health and Monash University, Melbourne, Australia.

The Peter Doherty Institute for Infection and Immunity, University of Melbourne and Royal Melbourne Hospital, Melbourne, Australia.

出版信息

AIDS Res Ther. 2020 Nov 10;17(1):65. doi: 10.1186/s12981-020-00321-z.

Abstract

BACKGROUND

Analytical treatment interruptions (ATI) are commonly used clinical endpoints to assess interventions aimed at curing HIV or achieving antiretroviral therapy (ART)-free HIV remission. Understanding the acceptability of ATI amongst people living with HIV (PLHIV) and their HIV healthcare providers (HHP) is limited.

METHODS

Two online surveys for PLHIV and HHP assessed awareness and acceptability of ATI, and understanding of the prospect for HIV cure in the future. Responses were collected from July 2017-January 2018. A descriptive analysis was performed and similar questions across the two surveys were compared using χ squared test.

RESULTS

442 PLHIV and 144 HHP completed the survey. 105/400 (26%) PLHIV had ever interrupted ART, 8% of which were in a clinical trial. Altruistic motivations were drivers of participation of PLHIV in cure related research. 81/135 (60%) HHP would support their patients wishing to enrol in an HIV cure-focused trial, but fewer would promote and allow such participation (25% and 31% respectively). Compared to HHP, PLHIV were more likely to believe that an HIV cure would be achievable within 10 years (55% vs. 19%, p < 0.001), had less awareness of ATI (46% vs. 62%, p < 0.001) and were less likely to have had experience of either participation or enrolment in an ATI study (5% vs. 18%, p < 0.001) CONCLUSION: PLHIV were more optimistic about the potential for HIV cure. HHP had more direct experience with HIV cure-focused studies. Educational strategies are required for both groups to increase understanding around ATIs in HIV cure research but should be tailored specifically to each group.

摘要

背景

分析性治疗中断(ATI)常用于评估旨在治愈 HIV 或实现无抗逆转录病毒治疗(ART)HIV 缓解的干预措施的临床终点。了解 HIV 感染者(PLHIV)及其 HIV 医疗保健提供者(HHP)对 ATI 的接受程度有限。

方法

对 PLHIV 和 HHP 进行了两项在线调查,以评估他们对 ATI 的认识和接受程度,以及对未来 HIV 治愈前景的理解。调查于 2017 年 7 月至 2018 年 1 月期间进行。进行了描述性分析,并使用卡方检验比较了两项调查中的相似问题。

结果

442 名 PLHIV 和 144 名 HHP 完成了调查。105/400(26%)的 PLHIV 曾中断过 ART,其中 8%的人在临床试验中。利他主义动机是 PLHIV 参与与治愈相关研究的驱动因素。81/135(60%)的 HHP 将支持他们的患者希望参加以 HIV 治愈为重点的试验,但愿意促进和允许这种参与的人数较少(分别为 25%和 31%)。与 HHP 相比,PLHIV 更有可能相信 HIV 治愈在 10 年内是可以实现的(55%比 19%,p<0.001),对 ATI 的认识较少(46%比 62%,p<0.001),并且更不可能有参与或参加 ATI 研究的经验(5%比 18%,p<0.001)。

结论

PLHIV 对 HIV 治愈的潜力更加乐观。HHP 对以 HIV 治愈为重点的研究有更多直接的经验。需要对这两个群体进行教育策略,以增加他们对 HIV 治愈研究中 ATI 的理解,但应根据每个群体的具体情况进行调整。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55b1/7653743/9a3d082f39d2/12981_2020_321_Fig1_HTML.jpg

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