课件：ART治疗指南解读.ppt

WHO Rationale for Earlier Treatment An earlier start to treatment reduces a person’s viral load much earlier in the course of their HIV infection, and thereby reduces the risk of onward HIV transmission and could potentially avert a significant number of new HIV infections. Earlier treatment could act as an incentive for more people to undergo voluntary counseling and testing without waiting to develop symptoms and fall sick. The incremental costs due to an additional one to two years on ART may be partly offset be decreased hospital and death costs, increased productivity due to fewer days sick, fewer children orphaned by AIDS and a drop in new HIV infections. * Survival from age 25 years.Cumulative survival curve for HIV-infected persons (without hepatitis C coinfection) and persons from the general population. Persons with HIV infection are divided into 3 calendar periods of observation. Dashed lines indicate 95% CIs. HIV = human immunodeficiency virus; HAART = highly active antiretroviral therapy. * * For more information, go to the Capsule Summary at /HIV/Conference%20Coverage/Retroviruses%202006/Capsules/525.aspx * * For more information, please see the Capsule Summary at /HIV/Conference%20Coverage/Retroviruses%202006/Capsules/530.aspx * This study evaluated whether deaths generally thought to be unrelated to HIV were more likely to occur in patients with low CD4+ count. The D:A:D is a prospective study of 23,441 patients from 11 existing cohorts in Europe, Australia, and USA. Detailed information regarding deaths occurring between initiation of D:A:D in 2000 and February 2004 were collected. Results showed that 5.3% of patients died over a 76,893 pt-yr of follow-up (incidence of death 1.6/100 pt-yr). 82% had used ART prior to enrolment for a median of 2.8 years. The leading cause of death was AIDS (30%). However, other causes included liver-related deaths, 9% were CV-related, and 8% were from non-AIDS malignancies. It was found that the proportion of dea