亚洲的艾滋病毒晚期呈现者:管理和公共卫生挑战
Chen Seong Wong1,2,3, Lyu Wei4, Yeon-Sook Kim5
1National Centre for Infectious Diseases, Singapore.
AIDS research and treatment
|June 23, 2023
概括
许多被诊断患有人类免疫缺陷病毒 (HIV) 的人是迟到的呈现者,面临更糟糕的健康结果和更高的传播风险. 提高认识,减少耻辱感和改善医疗保健提供者的转诊的策略对于亚洲的早期艾滋病毒诊断和治疗至关重要.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 流行病学 流行病学
背景情况:
- 人类免疫缺陷病毒 (HIV) 感染的晚期呈现在亚洲很常见,34-72%的诊断发生在晚期阶段.
- 晚期呈现者经历了更高的疾病负担,增加了机会性感染等并发症,并在联合抗逆转录病毒疗法 (cART) 后免疫恢复较差.
- 迟到的艾滋病毒诊断导致医疗保健成本增加,由于治疗和意识的延迟,社区传播的风险更高.
研究的目的:
- 定义晚期的艾滋病毒呈现,并突出其在亚洲的流行率和后果.
- 确定导致HIV诊断和治疗启动延迟的关键因素.
- 强调需要有效的战略来减少亚洲地区的晚期艾滋病毒呈现.
主要方法:
- 该研究基于CD4细胞计数低于350细胞/毫米3或在诊断时存在艾滋病定义疾病的存在来定义晚期的HIV呈现.
- 它审查了流行病学数据和亚洲背景下晚期呈现的临床影响.
- 讨论了导致迟到呈现的因素,包括耻辱,缺乏知识和医疗保健系统障碍.
主要成果:
- 晚期艾滋病毒呈现与显著的发病率,死亡率和较差的治疗结果有关.
- 对耻辱的恐惧,缺乏感知风险,知识不足和医疗保健提供者的转诊不足是早期艾滋病毒检测和诊断的主要障碍.
- 与早期主持人相比,迟到的演讲者具有更高的传输率.
结论:
- 迫切需要实施有效的战略,以减少亚洲晚期艾滋病毒呈现的发生率.
- 关键干预措施包括提高社区意识,打击与艾滋病毒检测相关的耻辱感,改善医疗保健提供者的早期检测和患者参与教育.
- 像患者坚持支持和艾滋病毒自我检测等倡议在改善检测机会和减少迟诊断方面表现有前途.
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