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过度敏感的病毒载荷测试对患有人类免疫缺陷病毒的人的危险

Maria G Rodriguez1, Alina Syros1, Allan E Rodriguez1

  • 1Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA.

Open forum infectious diseases
|October 18, 2023
PubMed

Insights

"不可检测=不可传播" (U=U) 的HIV概念至关重要. 目前的敏感测试在200拷贝/毫升以下会造成混乱,可能会对患者造成伤害,但没有明显的益处.

科学领域:

  • 病毒学 病毒学
  • 公共卫生 公共卫生
  • 传染性疾病 传染性疾病

背景情况:

  • "不可检测=不可传播" (U=U) 概念彻底改变了艾滋病毒的预防和治疗.
  • 从历史上看,HIV RNA病毒载荷 (VL) 低于200个拷贝/毫升定义了U=U研究的不可检测性.
  • 越来越敏感的VL测定现在检测到低于20副本/毫升的水平,导致定义混乱.

研究的目的:

  • 为了解决围绕HIV"不可检测"病毒载荷 (VL) 的定义的混.
  • 评估VLs在检测下限 (LLD) 和200拷贝/毫升之间的临床意义.
  • 提议改善VL报告和患者咨询有关艾滋病毒传播的情况.

主要方法:

  • 对U=U和病毒载荷测定现有研究的审查.
  • 分析高度敏感的VL测试对艾滋病毒管理的影响.
  • 讨论报告非常低VLs的临床益处和潜在危害.

主要成果:

  • 在LLD (例如,20拷贝/毫升) 和200拷贝/毫升之间的VL与未来的病毒学失败有关.
  • 在此范围内的VL患者中进行干预没有证明的临床益处.
  • 目前对低VL的报告实践可能是有害的,因为缺乏明显的好处.

结论:

  • 过于敏感的VL测试可以在U = U的背景下造成混乱和潜在的伤害.
  • 提出了调整VL报告门和加强提供商咨询的建议.
  • 需要进一步的研究来减轻与高度敏感的VL测试相关的危害,并澄清U = U定义.
抽象的

No abstract available in PubMed .

关键词:
艾滋病病毒 艾滋病病毒 艾滋病病毒治疗作为预防的治疗.病毒学失败 病毒学失败

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