tailieunhanh - báo cáo hóa học:" HIV treatment for prevention"

Tuyển tập các báo cáo nghiên cứu về hóa học được đăng trên tạp chí sinh học đề tài : HIV treatment for prevention | JOURNALOF THE INTERNATIONAL AIDS SOCIETY Ambrosioni et al. Journal of the International AIDS Society 2011 14 28 http content 14 1 28 REVIEW Open Access HIV treatment for prevention Juan Ambrosioni 1 Alexandra Calmy1 2 and Bernard Hirschel1 Abstract No virus no transmission. Studies have repeatedly shown that viral load the quantity of virus present in blood and sexual secretions is the strongest predictor of HIV transmission during unprotected sex or transmission from infected mother to child. Effective treatment lowers viral load to undetectable levels. If one could identify and treat all HIV-infected people immediately after infection the HIV AIDS epidemic would eventually disappear. Such a radical solution is currently unrealistic. In reality not all people get tested especially when they fear stigma and discrimination. Thus not all HIV-infected individuals are known. Of those HIV-positive individuals for whom the diagnosis is known not all of them have access to therapy agree to be treated or are taking therapy effectively. Some on effective treatment will stop and in others the development of resistance will lead to treatment failure. Furthermore resources are limited should we provide drugs to asymptomatic HIV-infected individuals without indication for treatment according to guidelines in order to prevent HIV transmission at the risk of diverting funding from sick patients in urgent need In fact the preventive potential of anti-HIV drugs is unknown. Modellers have tried to fill the gap but models differ depending on assumptions that are strongly debated. Further indications for antiretroviral treatments expand in places like Vancouver and San Francisco the majority of HIV-positive individuals are now under treatment and the incidence of new HIV infections has recently fallen. However correlation does not necessarily imply causation. Finally studies in couples where one partner is HIV-infected also appear to show that treatment reduces the

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