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【medical-news】HIV治疗应更早开始
London, United Kingdom
30 October 2006 01:41
Researchers have suggested that treatment of patients with HIV infections in South Africa should start at higher CD4 cell counts.
After studying untreated patients in the Cape Town area, they have identified a greater short-term risk of progression to Aids or death in South African patients with CD4 cell counts of 200-350 cells, compared to European and Australian patients with similar values and at the same clinical stage of the disease.
Their findings, published in the British medical journal The Lancet, were reported by the international AidsMap organisation on Monday.
The report noted that World Health Organisation (WHO) guidelines for the start of antiretroviral (ARV) therapy had been formulated after studies carried out in high-income countries and assessing mostly the long-term risk of disease progression.
Recommendations for lower-income countries had focused on CD4 cell counts, with treatment starting at CD4 values of less than 200.
The Cape Town study concluded that, due to the scarcity of laboratory and clinical tools to assess disease progression in sub-Saharan Africa, both the short-term risk of HIV/Aids and the short-term risk of death should be considered for the start of ARV therapy.
They hoped for the revision and refinement of WHO guidelines to start treatment at levels above 200, which they suggested could lead to the prevention of two-thirds of early deaths in patients in resource-limited settings.
There was also a AidsMap report published on Monday that said an emergency HIV/Aids drug supply service is to open in South Africa which will also serve other sub-Saharan countries.
Funded and initiated by the Dutch Ministry of Foreign Affairs and Development Cooperation, a buffer stock maintained in South Africa will offer a fall-back service to HIV/Aids treatment programmes in the region.
The service will be able to supply 80% of sub-Saharan Africa destinations within one week. Stocks will include generic -- usually cheaper -- versions of drugs patented in South Africa. - Sapa
http://www.mg.co.za/articlePage.aspx?articleid=288196&area=/breaking_news/breaking_news__national/ 应该及早开始HIV治疗
英国，伦敦
2006-10-30 01:41
国际爱滋病救助组织（international AidsMap organisation？）于星期一在英国医学杂志《柳叶刀》上发表了他们的研究数据。
他们对开普顿（好望角）地区未经治疗的HIV感染患者进行了研究，发现与欧洲和澳大利亚的同样情况的患者相比，南非地区的患者更容易在短期内病情恶化，在CD4阳性细胞计数在200-350个/L时就发生死亡。所以，他们建议南非地区的HIV感染患者应该在CD4阳性细胞数目还较高时就可是治疗（即，南非地区的HIV感染患者应该及早开始HIV治疗。）
开普顿实验的结论是，因为在撒哈拉沙漠附近的非洲地区，实验室和临床检测手段都很稀缺，所以如果存在HIV/Aids感染和死亡的短期风险，就要考虑开始ARV治疗。
这篇报道认为，世界卫生组织（World Health Organization，WHO）关于抗逆转录酶病毒(ARV)（一种致肿瘤病毒）治疗的指南明确指出在发达国家何时开始治疗以及如何最大程度的评估疾病进展的长期风险。指南中关于不发达国家的抗HIV治疗应该将注意力集中在CD4阳性细胞计数上，应该在CD4阳性细胞不低于200个/L时就开始治疗。
他们希望修订与完善WHO指南中关于CD4阳性细胞低于200个/L时才开始治疗的内容，他们认为如果及时治疗，可以利用有限的设备救治大部分（2/3）的死于HIV感染早期的患者。
本周一还发表了一个国际爱滋病救助项目的报告：现在，在南非地区开设了一个紧急提供HIV/Aids药物的医疗部门，同时负责供应撒哈拉沙漠附近的非洲地区国家的药物需要。
这是由荷兰外交事物与发展协作政府部门资助和发起的项目，是在南非地区持续存在并提供救助的缓冲库存（a buffer stock），在该地区主要为HIV/Aids治疗项目服务。这个机构能在一周内供应撒哈拉沙漠附近的非洲地区国家的药物需要。库存内容包括一般的药物——通常是比较便宜的药物——在南非地区获得专利的药物。- Sapa
http://www.mg.co.za/articlePage.aspx?articleid=288196&area=/breaking_news/breaking_news__national/
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作者:admin@医学,生命科学 2010-10-18 17:12
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