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在急诊科开始HIV病毒抑制治疗
原作者: Emilie J. B. Calvell 文章来源: 中华急诊医学杂志编辑部 发布日期:2013-04-22

Title: HIV viral suppression initiated in ED
题目:在急诊科开始HIV病毒抑制治疗
Author 作者: Emilie J. B. Calvello

Background Information 背景资料:
Combination antiretroviral therapy (cART) reduces HIV-associated morbidities and mortalities but cannot cure infection. Recent literature has suggested that early initiation of cART with primary infection  can lead to “functional cure” for HIV infected patients with suppressed viremia and delayed progression to clinical symptoms.
联合抗逆转录病毒疗法(cART)可以减少与HIV相关的并发症和死亡率,但不能治愈HIV感染。最新文献提示对原发性感染的病人早期使用cART可以“功能性治愈”患有HIV的病人,控制毒血症和延缓临床症状的发展。
Pertinent Study Design and Conclusions 有关研究设计和结论:
- Researchers studied 14 patients whose treatment with combination antiretrovirals began soon after exposure to HIV. The patients' viral loads became undetectable within roughly 3 months, and treatment was interrupted after about 3 years.
研究人员研究了14例在感染艾滋病毒后很快接受联合抗逆转录病毒药物治疗患者。患者的病毒負荷量在大约3个月内就检测不到了,並且治疗在3年后停止。
- The patients were found to have very low viral loads and stable CD4-cell counts after several years without therapy. The researchers estimate that about 15% of those treated early could achieve similar results.
停药几年后,患者具有非常低的病毒負荷量和稳定的CD4细胞计数。研究人员估计,约有15%的那些早期治疗病人可以达到类似的效果。
Bottom Line要点:
Have a high suspicion of acute HIV syndrome in the ED (fever, rash, pharyngitis, lymphadenopathy) and test properly (viral load NOT ELISA) to identify patients who may benefit from early, rapid initiation of cART.
在急诊科,要高度怀疑那些具有急性愛滋病毒感染综合征的表现(发热,皮疹,淋巴结肿大,咽炎)和适当检查(病毒负荷量而不是ELISA),以确定那些可能会受益于早期和快速的cART治疗的患者。
References 参考文献:
Sáez-Cirión A, Bacchus C, Hocqueloux L, Avettand-Fenoel V, Girault I, et al. (2013) Post-Treatment HIV-1 Controllers with a Long-Term Virological Remission after the Interruption of Early Initiated Antiretroviral Therapy ANRS VISCONTI Study. PLoS Pathog 9(3): e1003211.

文章来源:中华急诊医学杂志编辑部