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HIV感染のスクリーニング:米国予防サービスタスクフォースの勧告声明
, Douglas K Owens1,2, Karina W Davidson3
1Veterans Affairs Palo Alto Health Care System, Palo Alto, California.
JAMA
|June 12, 2019
まとめ
妊娠を含む15歳から65歳までのすべての青少年および成人のために,ヒト免疫不全ウイルス (HIV) 感染のスクリーニングが推奨されています. 早期発見と治療は HIVに関連する合併症や感染を減らすのに 重要な効果があります
科学分野:
- 公衆衛生
- 感染症
- 予防 医療
背景:
- HIVは米国では依然として重大な公衆衛生問題であり,何百万人もの人々が感染しており,青少年の診断数が著しく増加しています.
- 生後間HIV感染は重大な問題ですが,スクリーニングと介入により感染率は低下しています.
- 米国予防サービスタスクフォース (USPSTF) は以前,2013年に勧告を発行した.
研究 の 目的:
- 青少年,成人,妊婦のHIV検診に関する2013年USPSTFの勧告を更新する.
- HIV検診と治療戦略の利害を評価する.
主な方法:
- 検査の精度,スクリーニング間隔,治療開始の値を含む,HIVスクリーニングに関する証拠の体系的なレビュー.
- 妊婦と非妊婦の両方に対する抗レトロウイルス治療 (ART) の利益と害の評価
- 妊娠中の母から子へのHIV感染予防とARTの安全性に関する証拠のレビュー
主要な成果:
- 現在のHIV検査は極めて正確です
- HIVの早期発見と治療はエイズに関連した症例と死亡率を大幅に減少させます.
- 抗レトロウイルス治療 (ART) は性パートナーへのHIV感染と母から子への感染を大幅に減少させる.
- ARTは神経精神,腎臓,肝臓の効果を含むいくつかの害と関連しており,早産のリスクが増加しています.
結論:
- USPSTFは,15歳から65歳の青少年と成人,およびリスクの高い若者/高齢者のHIVスクリーニングを推奨しています.
- 全ての妊婦はHIV検査を受けるべきです 妊娠中の妊婦もです
- これらの集団におけるHIVスクリーニングの純利益は大きい.
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