Roughly, 38 million people are living with HIV worldwide. Despite the success of antiretroviral therapy (ART) for suppressing virus replication and restore immunity in infected persons, the HIV epidemics are not controlled globally. Each year 1.8 million new HIV infections occur. This rate has declined only slightly during the past decade, despite huge efforts for expanding ART coverage, pre- and post-exposure prophylaxis, and stopping vertical transmission. To achieve the United Nations Programme on HIV/AIDS goals of 95-95-95 by 2030, renewed efforts and innovative strategies must be undertaken. The source of most new HIV infections is people unaware of their HIV-positive status and/or not linked to care. Thus, efforts for unveiling HIV positives and, especially, rapid initiation of ART and retention in care would be the most effective interventions for halting HIV spreading globally. In certain settings, access to point-of-care diagnostic tests and immediate start of ART (even the same day) must be implemented at large scale. Selection of the most convenient ART to be prescribed empirically is an important caveat to minimize the risks of treatment failure. Ideally, it must be easy to take, coformulated as single-tablet regimen (STR), well tolerated, with no requests for prior human leukocyte antigen testing, depict few drug interactions, keep activity against transmitted drug-resistant viruses, remain efficacious in patients with elevated HIV-RNA, and/or low CD4 counts, and when present, suppress hepatitis B coinfection. At this time, the coformulation of darunavir, cobicistat, emtricitabine, and tenofovir alafenamide (Symtuza®) is the only regimen that has been evaluated in a Phase 3 trial as "test-and-treat" strategy. Results at 48 weeks in the DIAMOND study are reassuring, as more than 90% of individuals achieve undetectable viremia.

中文翻译：

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HIV诊断后快速开始抗逆转录病毒疗法。

全世界大约有3800万人感染艾滋病毒。尽管抗逆转录病毒疗法（ART）在抑制病毒复制和恢复感染者免疫力方面取得了成功，但艾滋病毒的流行尚未在全球范围内得到控制。每年有180万新的HIV感染发生。尽管在扩大抗逆转录病毒治疗的覆盖范围，暴露前和暴露后的预防以及停止垂直传播方面做出了巨大努力，但在过去十年中，该比率仅略有下降。为了在2030年前实现联合国艾滋病毒/艾滋病方案的目标是95-95-95，必须采取新的努力和创新的战略。大多数新的艾滋病毒感染源是人们不知道自己的艾滋病毒呈阳性状态和/或与护理无关。因此，努力揭露艾滋病毒阳性，尤其是 快速启动抗逆转录病毒疗法并保留在护理中将是阻止艾滋病毒在全球蔓延的最有效干预措施。在某些情况下，必须大规模实施即时护理诊断测试和立即开始抗病毒治疗（即使在同一天）。根据经验选择最方便的抗逆转录病毒疗法是一个重要的警告，它应尽量减少治疗失败的风险。理想情况下，它必须易于服用，作为单一片剂方案（STR）共同配制，耐受性好，无需事先进行人类白细胞抗原测试的要求，描绘出很少的药物相互作用，保持对传播的耐药性病毒的活性，在患者中仍然有效HIV-RNA升高和/或CD4计数低，并且在存在时抑制乙型肝炎合并感染。此时，达那那韦，cobicistat，恩曲他滨的联合制剂 Tenofovir alafenamide（Symtuza®）是唯一一项在3期临床试验中被评估为“试验与治疗”策略的方案。DIAMOND研究第48周的结果令人放心，因为超过90％的个体达到了不可检测的病毒血症。