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В бедных регионах раннее начало лечения ВИЧ может принести больше вреда, чем пользы

Хотя руководящие принципы лечения в США рекомендуют повсеместное лечение ВИЧ во всех случаях, преимущества такого подхода не всегда перевешивают недостатки, если речь идет о бедных регионах мира. Три исследователя из Университета Джонса Хопкинса опубликовали работу в журнале «Clinical Infectious Diseases», где утверждается, что из-за ограниченности доступности и непоследовательности лечения с помощью антиретровирусных (АРВ) препаратов, а также ограниченных возможностей лабораторных исследований, при применении американских стандартов лечения в бедных странах необходимо принять во внимание и некоторые другие аспекты.

Рекомендации по раннему началу лечения ВИЧ в США призваны улучшить перспективы состояния здоровья людей, живущих с ВИЧ, и пресечь передачу вируса другим людям. Очевидность этих преимуществ в последние годы выросла еще больше в связи с неуклонным снижением токсичности новых АРВ-препаратов. Исследователи из Университета Хопкинса утверждают, что раннее начало использования АРВ-препаратов в условиях ограниченности ресурсов, несомненно, несет с собой преимущества как для профилактических мероприятий, так и для людей с ВИЧ. Тем не менее, они утверждают, что, поскольку в таких условиях доступные препараты, как правило, являются устаревшими, люди, начинающие терапию при высоком уровне CD4, больше рискуют своим здоровьем из-за опасности побочных эффектов и токсичности препаратов. Кроме того, применение менее эффективных режимов лечения и недостаточность или отсутствие лабораторного контроля приводят к тому, что у людей развивается невосприимчивость к лекарствам, что в будущем может ограничить варианты лечения.

«Повсеместное, всеобъемлющее лечение должно быть нашей конечной целью, как для пользы самих ВИЧ-инфицированных, так и для замедления темпов распространения и в перспективе остановки эпидемии», — пишут авторы исследования. «Но за несомненными преимуществами АРТ нельзя терять из виду очевидные различия между странами, которые становятся препятствиями на пути применения АРТ».

Источник: aidsmeds.com

Ранее начало

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