Treatment as Prevention for HIV Infection: Current Data, Challenges, and Global Perspectives

被引:18
作者
Yombi, Jean C. [1 ]
Mertes, Helena [2 ]
机构
[1] Cliniques Univ, AIDS Reference Ctr, Dept Internal Med Infect Dis & Trop Med, Woluwe St Lambert, Belgium
[2] Ctr Hosp Univ Brugmann, Dept Infect Dis & Trop Med, Brussels, Belgium
关键词
HIV; Serodiscordant couples; Sexual transmission; Treatment as Prevention (TasP); 90-90-90; ACTIVE ANTIRETROVIRAL THERAPY; SUB-SAHARAN AFRICA; SERODISCORDANT COUPLES; SEXUAL TRANSMISSION; VIRAL LOAD; EPIDEMIC; CARE; INITIATION; RISK; ACQUISITION;
D O I
10.24875/AIDSRev.M18000024
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
In 2008, the Swiss National AIDS Commission issued a statement about the safety of HIV treatment in terms of reduced transmission in serodiscordant couples to reduce transmission in serodiscordant couples. This was subjected to debate until 2011 when the HIV prevention trial network 052 published the first randomized study about HIV transmission in serodiscordant couples, where no transmission was observed when the infected person was under effective antiretroviral treatment (ART). Later, the Partners of People on ART-A New Evaluation of the Risks (PARTNER) and the opposites attract studies, which first involved a large number of men who have sex with men (MSM), also showed no transmission, even in condomless receptive anal intercourse (CLAI). In this article, we first review the major studies' data showing the efficacy of ART in HIV transmission in serodiscordant couples at public health scale. Second, we discuss the implications and challenges behind the treatment as prevention strategy regarding the 90-90-90 UNAIDS targets to end the HIV epidemic.We now have strong evidence that ART reduces the risk of transmission of HIV from a positive partner to their negative partner. However, far beyond ART, combining prevention policies is crucial to avoid a new increase in the overall HIV incidence.
引用
收藏
页码:131 / 140
页数:10
相关论文
共 60 条
  • [1] [Anonymous], 16 INT AIDS C TOR
  • [2] [Anonymous], PIL STUD IMM ANT BEH
  • [3] [Anonymous], 2016, GUIDELINES USE ANTIR
  • [4] [Anonymous], GUID TREATM HIV 1 PO
  • [5] [Anonymous], CLIN MAN TREATM HIV
  • [6] [Anonymous], PREV GAP REP
  • [7] [Anonymous], PREVENT TEST TREAT A
  • [8] [Anonymous], 9 INT AIDS SOC C HIV
  • [9] [Anonymous], 2015, NAT HIV AIDS STRAT U
  • [10] Sexual transmission of HIV according to viral load and antiretroviral therapy: systematic review and meta-analysis
    Attia, Suzanna
    Egger, Matthias
    Mueller, Monika
    Zwahlen, Marcel
    Low, Nicola
    [J]. AIDS, 2009, 23 (11) : 1397 - 1404