In the past 16 years, the world has made tremendous achievements in dealing with AIDS and has curbed and reversed the spread of AIDS. Experts believe that the cure for AIDS is still an impossible task. However, after years of scientific research, huge investment in prevention and control, and long-term propaganda and education, AIDS has changed from a near death to a controlled chronic disease.
The first move: to start antiretroviral therapy for infected people as early as possible. This therapy is currently the main treatment for AIDS and is the biggest contributor to the progress of anti-AI. But in recent years, there has been a lot of controversy about when to intervene in treatment. There are three aspects in total: First, people are concerned about the long-term toxicity of antiviral drugs, especially cardiovascular side effects; Secondly, whether the suppression of viruses helps to avoid further Infecting others, including their sexual partners, and thirdly, whether the number of “CD4+ T cells†in the infected person is reduced to a certain extent and whether the intervention of conservative treatment is better.
A series of clinical studies conducted since 2006 have solved these questions. The overall conclusion is that the timely initiation of treatment once HIV infection is diagnosed will help to better control the condition and reduce the risk of transmitting the virus to others. The benefits it brings go far beyond the side effects. Anthony Fudge, director of the National Institute of Allergy and Infectious Diseases, commented: "HIV is much worse than (antiretroviral) drugs."
It is on the basis of these scientific evidence that the World Health Organization recently revised the anti-asthma guidelines and recommended that all infected people be treated as soon as possible, regardless of the number of "CD4+ T cells" in their bodies.
The second measure: to strengthen the prevention of high-risk groups. People at high risk of HIV infection include gays, especially gay men and drug injectors. Organizations such as the World Health Organization and the US Centers for Disease Control and Prevention strongly recommend that high-risk groups should adopt “pre-exposure prophylaxis†measures to prevent AIDS, that is, taking a special pill every day to prevent HIV infection.
In 2012, the U.S. government approved a compound called Truvada as a "pre-exposure prophylaxis" drug. Studies have shown that men who have sex with men take Truvada every day can reduce the risk of infection by 90%, and for injection drug users who share syringes, the risk of infection can be reduced by more than 70%.
However, the US Center for Disease Control issued a report last week that even in the United States, one-third of primary care physicians and nurses have never heard of such prevention strategies. In addition, how to ensure compliance with medication for high-risk groups has also become a problem. If you take it intermittently, it will not only be detrimental to your own health, but also increase the risk of HIV resistance and transmission of resistant virus to others. At present, some pharmaceutical companies are developing long-acting drugs to solve compliance problems. In the future, infected people will only need to take drugs once a month instead of using them every day.
The third measure: to strengthen AIDS testing and improve treatment coverage. Even in developed countries such as the United States, 12.5% ​​of people do not know they are infected with HIV. In the United States, about 50,000 new infections occur each year, and nearly one-third of these infections are those who do not know. In the world, the proportion of people who do not know that they are infected with the virus is as high as 45%.
As UNAIDS stated in its statement issued on November 30, “Assessment is the key first step in obtaining life-saving antiretroviral therapy for people living with HIV.†Given the importance of testing, some medical institutions such as the United States The Prevention Services Working Group recommends that HIV testing should be included in the routine screening.
Once all infected individuals are informed and begin to receive treatment, the number of new infections will inevitably greatly decrease. The United Nations Programme on HIV/AIDS (UNAIDS) proposed last year to achieve the “90-90-90†target by 2020. Specifically, 90% of HIV-infected people are aware of themselves, and 90% of those infected with HIV-infected individuals have received treatment and 90% have received treatment. Suppressed. By 2030, the proportion of specific targets will increase to 95%.
In addition, more targeted prevention and control strategies should be adopted for some new trends. For example, a report released by UNICEF at the end of November shows that the number of young people who died of AIDS has tripled over the past 15 years. Therefore, the international community should strive to provide more channels for treatment, care and support for young people living with HIV. Recent studies conducted by the US Centers for Disease Control and Prevention in 12 developing countries show that women in developing countries have more opportunities than men to participate in HIV testing and have greater access to treatment, and in most countries, this gender imbalance Increasingly obvious. Obviously, some countries should increase targeted HIV screening opportunities for men.
Of course, the development of safe and effective AIDS vaccines or cures is a permanent solution. A few years ago, a landmark clinical trial in Thailand showed that an AIDS vaccine called RV144 reduced the risk of human infection by 31%. Scientists further developed the HVTN 100 vaccine based on RV144, and started relevant clinical research in South Africa in February this year. In addition, a series of significant advances have also been made this year in new anti-Ai drugs, therapeutic antibodies and rapid detection technologies.
The National Institutes of Health of the United States stated in its statement for the World AIDS Day on November 30th: “When the first AIDS cases were reported in 1981, scientists and doctors did not know what caused AIDS and did not treat those infected. The drugs. But over time, doctors today can provide patients with very effective treatment and prevention drugs. We can now confidently say that ending the AIDS epidemic is just around the corner."
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