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来自世界艾滋病大会前沿信息提示—— 调整战术 控制艾滋病传播蔓延
2010-08-12 来源：健康报 我要评论(0)
□本报记者 郑灵巧□
每两年一届的世界艾滋病大会近期在维也纳举行，此届大会所展示的艾滋病防控重大进展是什么？参加会议的中国疾病预防控制中心性病艾滋病预防控制中心主任吴尊友博士的回答是，有效阻止艾滋病传播的研究进展最显著，只是防控艾滋病的传播蔓延仍很艰难。
●“鸡尾酒疗法”显现预防功效
与以往观察视角不同，一组研究人员在本届世界艾滋病大会上报告的“鸡尾酒疗法”（高效抗逆转录病毒治疗方法）的显效是，这一疗法不仅遏制了艾滋病患者的病情发展，也大幅降低了艾滋病病毒经性途径感染的可能性。
研究发现，对于夫妻单方感染家庭的观察显示，感染的一方经抗病毒治疗后，其配偶与其性接触感染的风险降低了90%。此届大会报告的在加拿大不列颠哥伦比亚省开展的研究也显示，该省自1996年引入“鸡尾酒疗法”以来，艾滋病新病例数量减少了52%，平均每增加100名艾滋病感染者接受“鸡尾酒疗法”，每年社会上即可减少艾滋病病毒新感染者3人。与此相对应的是，当地其他以性行为为传播途径的新病例仍在增多。这表明该地艾滋病新病例、新感染者减少的原因并非是使用安全套或性行为减少等因素，而是“鸡尾酒疗法”应用使然。
吴尊友认为，这些研究提示，抗病毒治疗也是一种预防手段。对于接受治疗人群而言，治疗可以有效预防机体从感染状态进展到发病状态；对于未感染的社会一般人群而言，感染人群经治疗减少了所携带艾滋病病毒的数量，其传播能力由此减弱。由此，抗病毒治疗有望成为今后防控艾滋病传播策略的重要组成部分，而不再仅仅被看做是保护艾滋病病人的措施。
●价格昂贵使新成果难惠及贫困人群
本届世界艾滋病大会报告的一种新研制的抗艾杀菌剂——加入抗逆转录病毒药物的阴道凝胶，以显著降低女性因性行为感染艾滋病的几率，又可由女性自主控制使用，而被誉为艾滋病预防领域的“重要里程碑”。
吴尊友说，这一科研成果令人鼓舞， 但距离推广应用还有一个过程。目前，无论通过“鸡尾酒疗法”进行抗艾滋病病毒治疗，还是应用这一新技术手段，都主要依赖抗艾滋病病毒药物。而抗艾滋病病毒药物费用高昂，在很多发展中国家，艾滋病病毒感染者根本承担不起。因此，帮助发展中国家控制疫情传播应该成为发达国家义不容辞的责任。
●我国治疗“门槛”已率先降低
在此次大会召开前，联合国艾滋病规划署通过专家论证，提出了“2.0 治疗方案”艾滋病防治计划。吴尊友即是应邀参加论证的专家之一。
吴尊友介绍，“2.0 治疗方案”并非一个具体的治疗操作文本，而是一种理想的治疗方向和新的治疗理念。它包括降低抗病毒治疗价格，减少药物副作用，将现用几个药物组合成一个方剂等。该方案两大愿景是：挽救更多艾滋病患者生命，避免更多人成为艾滋病病毒感染者。
在此次大会上，世界卫生组织也推出了有关艾滋病治疗的新推荐意见，降低治疗“门槛”，及早治疗艾滋病病毒感染者，可有效防止感染者因免疫系统缺陷感染结核病等其他疾病而死亡。
据悉，我国已率先调整抗艾滋病病毒治疗策略与措施。早在2007年，我国就降低了抗艾滋病病毒治疗“门槛”，将治疗起始标准改订为感染者体内的CD4免疫细胞降至每立方毫米350个，而不再等到以往标定的降至200个。该标准与世界卫生组织在本届大会上出台的新标准一致。
- 艾滋病早期治疗是康复与延长30～60年生命的保
- 艾滋病免疫重建的重要意义是挽救生命的根本
- 从食品植物研究开发的治疗艾滋病新药三合皂甙
- 康生丹颗粒免疫实验提示符合艾滋病、肿瘤等应
- 鸡尾酒疗法并非万能，抗药性与毒副作用导致联合疗法与中药疗法应用的迫切性
- 康生丹配合西药治疗AIDS总结
- 三合皂甙，康生丹片
- 中药康生丹治愈艾滋病中医论析
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Cutting-edge information from the World AIDS Conference tips - to adjust tactics control the spread of HIV transmission
2010-08-12 Source: Health News I want to comment (0)
□ □ smart reporter Zheng
Every two years the World AIDS Conference held recently in Vienna, this session of the General Assembly demonstrated significant progress in AIDS prevention and control of what? Participate in the meeting of the China Centre for Disease Control and Prevention Director, Centre for STD and AIDS Control and Prevention Dr. Wu Zunyou answer is, effectively prevent the spread of AIDS, the most significant progress, but the spread of AIDS prevention and control is still very difficult.
● "cocktail therapy" show the effectiveness of prevention
Different perspective on the past, a group of researchers reported at the World AIDS Conference, the "cocktail therapy" (highly active antiretroviral therapy) is markedly effective, this therapy not only suppresses the development of AIDS disease, but also significantly reducing HIV infection through sexual means the possibility.
Study showed that for couples families observations unilateral infection, infection of the party by the anti-viral treatment, the spouse with lower risk of sexually transmitted infections by 90%. This session of the Assembly of British Columbia in Canada to carry out the study also showed that the province since 1996 introduction of the "cocktail therapy" since the number of new cases of AIDS decreased by 52%, the average increase of 100 per HIV infection were treated with "cocktail therapy" each community can reduce new HIV infections 3. Correspondingly, is to sex as the other local transmission of new cases is still increasing. This indicates that the place of new cases of AIDS, reduction of new infections is not due to decreased use of condoms or sexual behavior and other factors, but the "cocktail therapy" applied 使然.
WU Zun that these studies suggest that antiretroviral therapy is also a means of prevention. For people receiving treatment, the treatment can be effective in preventing the body from infection progressed to the disease state of the state; for the general population not infected, the infected people were treated with HIV by reducing the amount of this reduced its ability to communicate. Thus, antiviral treatment is expected to be in the future spread of AIDS prevention and control of an important part of the strategy, rather than just be seen as measures to protect AIDS patients.
● expensive to make new achievements to benefit the poor hard
Report at the World AIDS Conference, a new fungicide developed anti-Ai - join anti-retroviral drugs, vaginal gel, to significantly reduce female sexual behavior due to risk of HIV infection, but also by the use of female self-control, was AIDS prevention in the field praised the "important milestone."
Mr Wu said that the research results are encouraging, but there is a process from the popularization and application. At present, whether by "cocktail therapy" for anti-HIV treatment, or application of this new technological means, are mainly dependent on anti-HIV drugs. The high cost of anti-HIV drugs, in many developing countries, HIV infection simply can not afford. Therefore, to help developing countries control the spread of the epidemic should be incumbent upon the developed countries.
● China's treatment of "threshold" has taken the lead reduction
Held in the General Assembly before the UNAIDS demonstrated by experts, proposed the "2.0 treatment" of AIDS prevention programs. Mr Wu is one of the experts invited to participate in arguments.
Mr Wu said that "2.0 treatment" is not a specific treatment for operational text, but an ideal therapeutic direction and new treatment concept. It includes lowering the price of antiviral therapy to reduce side effects, the use of several drugs are combined into a prescriptions. Two visions of the program are: to save more lives of AIDS patients to prevent more people becoming infected with HIV.
In the General Assembly, the World Health Organization has also introduced the new treatment on AIDS recommended Yi Jian, Jiang Di treatment "threshold", early treatment of HIV infection can be effective to prevent diseases whose immune Jitongquexian TB Deng infection of other diseases.
It is reported that China has adjusted the first anti-HIV treatment strategies and measures. As early as 2007, China will reduce the anti-HIV treatment "threshold", will start the standard treatment for the infection set to change the body's CD4 immune cells dropped to 350 per cubic millimeter, instead of the previous calibration until reduced to 200 . The standards and the World Health Organization issued at this meeting the new standards.
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