Balogun Kayode, Slev Patricia R
University of Utah, Department of Pathology, United States; ARUP Institute of Experimental Pathology, ARUP Laboratories, United States.
Clin Biochem. 2023 Jul;117:53-59. doi: 10.1016/j.clinbiochem.2022.05.006. Epub 2022 May 28.
We are entering the 5th decade of the HIV epidemic and although there is no cure, critical advances have been made in treatment, prevention and diagnostics, transforming HIV into a survivable disease. Due to these advances, the UNAIDS has set a goal of "90-90-90" target by 2020, which has been extended now to 2030, to have 90% of individuals infected with HIV diagnosed, 90% of those diagnosed linked to care and 90% of people receiving ART and 90% of those receiving ART achieving an undetectable viral load. Today, the focus is on U = U, "undetectable equals untransmittable", which takes advantage of improved diagnostics and treatment and preventive therapies that are combined with scale-up strategies. This article will review the advances in testing strategies and diagnostics, including rapid diagnostic tests and next generation sequencing, as well as the challenges that pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) now present for diagnosing and managing HIV infection.
我们正步入艾滋病流行的第五个十年，尽管尚无治愈方法，但在治疗、预防和诊断方面已取得关键进展，将艾滋病转变为一种可生存的疾病。由于这些进展，联合国艾滋病规划署设定了到2020年实现“90-90-90”目标，现该目标已延至2030年，即让90%的艾滋病毒感染者得到诊断，90%被诊断者获得治疗，90%接受抗逆转录病毒治疗者病毒载量降至检测不到水平。如今，重点是“U=U”，即“检测不到等于不具传染性”，这利用了改进的诊断、治疗和预防性疗法，并结合了扩大治疗规模的策略。本文将回顾检测策略和诊断方面的进展，包括快速诊断检测和下一代测序，以及暴露前预防（PrEP）和暴露后预防（PEP）目前在艾滋病毒感染诊断和管理中面临的挑战。
