European infectious disease最新文献

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Expanded Highly Active Antiretroviral Therapy Coverage - A Powerful Strategy to Curb Progression to AIDS, Death and New Infections. 扩大高活性抗逆转录病毒治疗的覆盖范围——遏制艾滋病进展、死亡和新感染的有力战略。

European infectious disease

Pub Date : 2009-01-01

Aranka Anema, Viviane D Lima, Karissa Johnston, Adrian Levy, Julio Sg Montaner

Sustained combination of HIV prevention strategies is essential to curb the spread of the HIV/AIDS epidemic. The use of highly active antiretroviral therapy (HAART) decreases morbidity and mortality, as well as HIV transmission, among treated individuals. The concept of 'treatment as prevention' is dependent on HAART's ability to sustain HIV-1 RNA virological suppression at the individual and population levels, and has been demonstrated in studies evaluating transmission in mother-to-child, sero-discordant couples and large treated populations. The worldwide expansion of maximally effective antiretroviral drug regimens has been coupled with concerns regarding the magnitude of the financial investment required. However, HAART's compounding effect on reduced morbidity, mortality and transmission makes the expansion of HAART coverage highly cost-averting. Building on a mathematical model that evaluated the impact of expanded HAART access on viral load in a Canadian setting, we demonstrate that an investment of CA$249 million over the lifetime of treated individuals would result in a net gain of CA$2.1 billion over 30 years. This provides a powerful economic incentive to rapidly scale up HAART access worldwide.

艾滋病毒预防战略的持续结合对于遏制艾滋病毒/艾滋病的蔓延至关重要。使用高效抗逆转录病毒疗法(HAART)可降低接受治疗人群的发病率和死亡率以及艾滋病毒传播。“治疗即预防”的概念取决于HAART在个体和群体水平上维持HIV-1 RNA病毒学抑制的能力，并已在评估母婴传播、血清不一致夫妇和大量接受治疗人群的研究中得到证实。在世界范围内扩大最有效的抗逆转录病毒药物治疗方案的同时，人们对所需财政投资的规模感到关切。然而，高效抗逆转录病毒疗法在降低发病率、死亡率和传播方面的复合效应使得扩大高效抗逆转录病毒疗法的覆盖范围大大节省了成本。建立一个数学模型，评估在加拿大环境中扩大HAART获取对病毒载量的影响，我们证明在接受治疗的个体的一生中投资2.49亿加元将在30年内产生21亿加元的净收益。这为在世界范围内迅速扩大HAART治疗提供了强大的经济激励。

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