人类免疫缺陷病毒感染快速启动抗逆转录病毒治疗研究及模式探索

Research progress on rapid initiation of antiretroviral therapy for human immunodeficiency virus infection and model exploration Q

2017年世界卫生组织发出人类免疫缺陷病毒(HIV)感染者“发现即治疗”的倡议,2023年我国在诸多国际指南的基础上颁布了《快速启动艾滋病抗病毒治疗专家共识》,建议所有HIV感染者于确诊7日内启动抗逆转录病毒治疗(ART),甚至在确诊当天即启动ART。该模式可提高治疗覆盖率和治疗队列保持率、ART成功率以及降低病死率等。我国已采取了多种措施以推动快速启动ART模式,但该治疗模式的推行仍面临来自患者以及获得性免疫缺陷综合征(AIDS)治疗管理等结构因素的挑战。可通过加强医防融合,简化转介流程、探索流动人口转介治疗模式、加强医务人员快速启动ART理念和能力培训、提高实验室报告及时性和ART药物可及性等方面完善进一步的探索调整,以建立符合我国国情的可持续快速启动ART模式。本文对HIV感染者快速启动ART研究现状和启动ART模式进行综述。

The World Health Organization issued the"Treat all"initiative for human immunodeficiency virus(HIV)-positive individuals in 2017.Based on many international guidelines,an expert consensus on the rapid initiation of antiretroviral therapy(ART)in 2023 was issued in China,recommending that all HIV-positive individuals start ART within 7 days after diagnosis,or even on the same day as diagnosis.This model has benefits such as increasing treatment coverage and retention rates,improving ART success rates,and reducing mortality rates.China has implemented various measures to promote the rapid initiation of ART,but the implementation of this treatment model stil faces challenges from patient-related and structural factors such as HIV treatment management.Further exploration and adjustments can be made by enhancing the integration of medical and preventive care,simplifying referral processes,exploring referral treatment models for mobile populations,strengthening training for healthcare professionals on rapid initiation concepts and capabilities,improving the timeliness of laboratory reports,and increasing the accessibility of ART medications,in order to establish a sustainable rapid start model suited to national conditions of China.This review summarizes the current research status and rapid initiation ART in individuals with HIV infection.