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生殖器疹的血清查:美国预防服务工作组的最新证据报告和系统审查
Cynthia Feltner1, Catherine Grodensky2, Charles Ebel3
1RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center2Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill3Department of Medicine, University of North Carolina at Chapel Hill.
JAMA
|December 21, 2016
概括
检查生殖器疹简单病毒 (HSV) 感染的错误阳性和潜在危害率很高. 目前还没有证据表明预防性抗病毒药物是否有助于无症状的HSV-2感染.
科学领域:
- 公共卫生
- 传染性疾病
- 查和诊断
背景情况:
- 生殖器疹简单病毒 (HSV) 感染是一种常见的性传播感染.
- 垂直传播的HSV对胎儿健康构成风险.
- 无症状感染很常见,并带来诊断上的挑战.
研究的目的:
- 评估无症状个体的生殖器HSV血清查的证据.
- 评估生殖器HSV感染的预防性干预措施.
- 根据美国预防服务工作组的最新建议.
主要方法:
- 随机临床试验 (RCT) 和准确性研究的系统审查.
- 搜索了MEDLINE,科克伦图书馆,EMBASE和试验注册表.
- 使用ROC分析进行选试验的综合灵敏度和特异性.
主要成果:
- 没有RCT比较查与没有查.
- 查测试显示高灵敏度但具有可变的特异性,在一般人群中产生50%的阳性预测值.
- 查与社会心理上的伤害有关,
- 预防性药物试验产生了异质和不一致的结果.
结论:
- 生殖器疹的血清查与显著的错误阳性结果和潜在的社会心理伤害有关.
- 目前的证据没有证实预防性抗病毒药物对无症状的HSV-2有好处.
- 需要进一步的研究来澄清查和治疗的作用.
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