A PubMed and EMBASE databases search up to December 2019 resulted in 1918 articles, of which 209 were included in this review; 84 studies presented in major HIV conferences were also included. Studies that did not provide explicit definitions, modelling studies and those reporting only on metrics for subpopulations or factors affecting a CoC stage were excluded. Included articles reported results on 1 to 6 CoC stages.
Percentage treated and virally suppressed was reported in 78%, percentage diagnosed and retained in care in 58%, percentage linked to care in 54% and PLHIV in 36% of the articles. Information for all stages was provided in 23 studies. Only 6 articles use novel CoC estimates: One presents a dynamic CoC based on multistate analysis techniques, two base their time-to-next-stage estimates on a risk estimation method based on the cumulative incidence function, weighted for confounding and censoring and three studies estimated the HIV infection time based on mathematical modelling.
A limited number of studies provide elaborated time analyses of the CoC. Although time analyses lack the straightforward interpretation of the cross-sectional CoC, they provide valuable insights for the timely response to the HIV epidemic. A future goal would be to develop a model that retains the simplicity of the cross-sectional CoC but also incorporates timing between stages.
截至2019年12月的PubMed和EMBASE数据库搜索产生了1918篇文章,其中209项被纳入本综述;84项在主要HIV会议上发表的研究也被纳入.没有提供明确定义的研究,模型研究和仅报告亚群或影响CoC分期的因素的指标的研究被排除.纳入的文章报告了1至6个CoC阶段的结果。
据报道,治疗和病毒抑制的百分比为78%,诊断和保留在护理中的百分比为58%,与护理相关的百分比为54%,与PLHIV相关的百分比为36%。23项研究提供了所有阶段的信息。只有6篇文章使用了新的CoC估计:一篇文章提出了基于多状态分析技术的动态CoC,两个基于累积发生率函数的风险估计方法,加权混淆和审查,三项研究基于数学建模估计了艾滋病毒感染时间。
有限数量的研究提供了CoC的详细时间分析。尽管时间分析缺乏对横截面CoC的直接解释,它们为及时应对艾滋病毒流行提供了宝贵的见解。未来的目标是开发一种模型,该模型保留了横截面CoC的简单性,但也包含了阶段之间的时序。