[新聞] 愛滋病指南為男同性戀者制定特別HPV建議消失

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1.媒體來源: ※ 例如蘋果日報、奇摩新聞 Medscape 2.完整新聞標題: ※ 標題沒有寫出來 ---> 依照板規刪除文章 HIV Guidelines Make Special HPV Recommendations for Gay Men 3.完整新聞內文: ※ 社論特稿都不能貼! 違者刪除(政治類水桶3個月)，貼廣告也會被刪除喔! Heather Boerner October 27, 2017 MILAN — Gay and bisexual men with HIV should get vaccinated for human papillomavirus (HPV) up until age 40, according to updated guidelines from the European AIDS Clinical Society (EACS), released this week at the 16th European AIDS Conference. And others with HIV should be vaccinated until age 26, the guidelines state. 根據在本周米蘭舉行的第十六屆歐洲愛滋病學術會所發布的指南同性戀及雙性戀男性應注射HPV疫苗直到40歲其他愛滋病感染者需注射疫苗直到26歲 "We wanted to make a strong point that patients with HIV infection, and gay men in particular, should get vaccinated," said Georg Behrens, MD, PhD, from the Hannover Medical School in Germany, who is chair of the comorbidities subcommittee of the EACS guidelines panel. 來自德國漢諾威醫學大學的Georg Behrens博士表示 "我們希望加強愛滋病感染者尤其是男同性戀者注射HPV疫苗" 他同時也是該學術會的主席 This differs from the US guidelines, which call for both men and women to be vaccinated for HPV until age 26 if they weren't vaccinated as preteens or teenagers, but make no special recommendations for gay or bisexual men. 與美國的指南不同的是若青年時期未注射HPV疫苗則要求男性及女性持續注射至26歲但未對同性戀及雙性戀男性有所提及 Emerging data show that HPV-related cancers are growing in prevalence in all people with HIV, including gay men. 而新出爐的數據顯示 HIV感染者罹患HPV相關癌症的得病率正在上升其中也包括男同性戀者 HPV-related Cancers HPV相關癌症 People with HIV are 19 times more likely than those without HIV to be diagnosed with anal cancer, and women with HIV are three times more likely to be diagnosed with cervical cancer, according to the National Cancer Institute. 根據國家癌症研究院指出愛滋病患者在與非愛滋病患者相比下罹患肛門癌的可能性高除 19倍而子宮頸癌則是3倍 Gay men with HIV are nearly five times as likely as those without HIV to develop anal cancer, one study reports (J Acquir Immune Defic SynDr. 2008;48:491-499). 而根據一項報告中指出男同性戀愛滋病患者在得肛門癌的機率是未得愛滋病的將近5倍 A poster also presented at the meeting showed that gay men with HIV who are older than 50 years have a lifetime risk for HPV-related anal cancers of 2.8%, which the Australian researchers called "alarmingly high." In contrast, women younger than 50 years have a lifetime risk for anal cancer of 0.2%. 而會議中一張海報中指出 50歲以上愛滋感染之同性戀男性在終其一生罹患HPV相關癌症肛門癌的風險為2.8% 而50歲以下女性終其一生罹患肛門癌的風險為0.2% 澳洲研究人員表示這是驚人的高 But until this year, EACS guidelines for HPV vaccination did not include men at all, said Dr Behrens. This is the case for guidelines from many countries, including his home of Germany. Behrens博士說直到今年 HPV疫苗接中仍不包括男性這是許多國家的準則也包含他的家鄉德國 "As chair of the panel, I was surprised" by the recommendation, Dr Behrens acknowledged. "But there was more or less agreement that we should move forward with this." 作為此小組討論會的主席 Behrens博士表示我相當驚訝但是再或多或少的會議中我們需要再持續推進 The recommendations are part of a larger "rigorous approach to screening for detection of precancers under the guidelines," said Lene Ryom, MD, PhD, from the University of Copenhagen, who is assistant guidelines coordinator. 來自根本哈根大學的Lene Ryom博士說這些建議僅僅只是在更嚴格篩檢去發現癌前病變的一部份 Although the effect of the vaccine on adults who have already encountered high-risk strains of HPV is unclear, the aggressiveness of anal and other HPV cancers warrant the change, Dr Ryom told Medscape Medical News. 雖然疫苗的成效在成年人遇上高風險HPV病毒仍然不明但對於HPV型癌症及肛門癌的侵略已有改變 Ryom博士告述Medscape Medical News Antiretrovirals, Comorbidities, and ICU Guidelines 抗轉錄病毒藥物合併症及 ICU指南 The new guidelines also include updates related to antiretroviral therapy. Dolutegravir plus rilpivirine combination therapy has been added as an option, reflecting results from the SWORD 1 and 2 trials. 新指南也同時更新了抗逆轉錄病毒治療新增了Dolutegravir加利妥結合聯合治療作為選擇反映了SWORD 1和2試驗的結果 Possible cardiovascular events associated with darunavir are now mentioned, reflecting findings from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study. The combination of lopinavir plus ritonavir — an old regimen — has been removed as an option. And a description of when to use the older formulation of tenofovir instead of the new prodrug tenofovir alafenamide has been added. 新版本也提及地瑞那韋相關的可能性心血管事件也反映了"抗艾滋病藥物不良事件數據收集（D：A：D）"研究的結果洛匹那韋加利托那韋-老方案的組合已被刪除作為選擇並且已經添加了描述何時使用替諾福韋的舊製劑而不是新的前藥替諾福韋甲酰胺 But the most comprehensive guidance comes in discussions about comorbidities, drug–drug interactions, and doctors in the intensive care unit who care for severely ill people with HIV. 但是最全面的指導意見是關於合併症藥物相互作用以及關心愛滋病毒嚴重感染者的重症監護病房的醫生的討論 "I said, 'this must be included in the EACS guidelines'," said Manuel Battegay, MD, from the University Hospital of Basel in Switzerland, who is guidelines coordinator. "It's always the same question from intensive care: Can we give this ARV, and how — in the tube, or crushed, or whatever?" 來自瑞士巴塞爾大學醫院的Manuel Battegay醫生說 "我必須將這包括在EACS指南中" "重症監護病毒始終是同一個問題我們可以給予這種ARV 但是要如何做用管或是壓碎或是其他" For example, he pointed out, tenofovir should be swallowed whole, not chewed, broken, cut, or crushed, whereas other drugs can be dissolved in water. 例如他指出替諾福韋應該吞嚥不要咀嚼破碎切碎或粉碎然而其他藥物可以溶解在水中 The updated guidelines also include comorbidity sections on pulmonary disease and nonalcoholic fatty liver disease. And for the comorbidity section on solid organ transplant, it is recommended that the same criteria applied to the general public be applied to people living with suppressed HIV. 更新的指南還包括肺部疾病和非酒精性脂肪肝疾病的合併部分對於實體器官移植的合併部分建議將適用於公眾的相同標準適用於愛滋病毒感染者 Overall, the guidelines move the field toward helping patients through a long life with HIV, said Dr Ryom. Ryom博士說總體而言這些指導方針將幫助患者長期維持愛滋病毒治療 The decision to use a specific antiretroviral or to switch regimens should be made on the basis of a patient's risk profile. "Throughout the guidelines, there's a strong aim toward doing personalized medicine. A lot of energy goes into making those particular considerations with your patients," she added. 使用特定抗逆轉錄病毒藥物或切換方案的決定應根據患者的風險狀況進行 "在整個指導方針中強烈的目標是要做個人化的藥物大量的精力用於對患者進行這些特殊的考慮" 她補充說 Dr Behrens has received grant funding from Gilead Sciences, Abbott, ViiV Healthcare, and MSD, and has served as a speaker for Gilead, ViiV, MSD, Janssen, and Hexal AG. Dr Ryom and Dr Battegay have disclosed no relevant financial relationships. 16th European AIDS Conference. Presented October 26, 2017. 4.完整新聞連結 (或短網址): ※ 當新聞連結過長時，需提供短網址方便網友點擊 https://www.medscape.com/viewarticle/887731 5.備註: ※ 一個人一天只能張貼一則新聞，被刪或自刪也算額度內，超貼者水桶，請注意大致上有翻最後幾段懶著翻大部分參考GOOGLE 如果有翻錯的地方麻煩提醒謝謝 -- ※ 發信站: 批踢踢實業坊(ptt.cc), 來自: 36.227.60.177 ※ 文章網址: https://www.ptt.cc/bbs/Gossiping/M.1509164967.A.23D.html

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