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  3. Surveys by the World Health Organization (WHO) reveal that, in the past 4 years, 12 countries in Africa, Asia and the Americas h

Surveys by the World Health Organization (WHO) reveal that, in the past 4 years, 12 countries in Africa, Asia and the Americas h

admin2021-06-15  1
问题         Surveys by the World Health Organization (WHO) reveal that, in the past 4 years, 12 countries in Africa, Asia and the Americas have surpassed acceptable levels of drug resistance against two drugs that constitute the backbone of HIV treatment: efavirenz and nevirapine.
        People living with HIV are routinely treated with a cocktail of drugs, known as antiretroviral therapy, but the virus can mutate into a resistant form.
        The WHO conducted surveys from 2014 to 2018 in randomly selected clinics in 18 countries, and examined the levels of resistance in people who had started HIV treatment during that period.
        More than 10% of adults with the virus have developed resistance to these drugs in 12 nations (see "Resistance rises"). Above this threshold, it’s not considered safe to prescribe the same HIV medicines to the rest of the population, because resistance could increase. Researchers published the findings this month in WHO report.
        "I think we have kind of crossed the line," says Massimo Ghidinelli, an infectious-disease specialist at the Pan American Health Organization in Washington DC.
        Overall, 12% of women surveyed had a drug-resistant form of HIV, compared with 8% of men.
        Particularly concerning, says the report, is the high level of resistance in infants with HIV in sub-Saharan Africa. Between 2012 and 2018, about one-half of newly diagnosed infants in nine of the countries in this region had a form of HIV that was resistant to efavirenz, nevirapine or both.
        The causes of drug resistance remain elusive, says Silvia Bertagnolio, an infectious-disease physician at the WHO in Geneva, Switzerland, and co-author of the report. But drug-resistant HIV might develop when people interrupt treatment, she suggests.
        For example, many women living with the virus might have taken antiretrovirals during pregnancy to prevent their babies from becoming infected, but stopped after delivery. The WHO recommended this practice until 2015, when it suggested that pregnant and breastfeeding women use the drugs for life.
        The prevalence of resistance in people who restarted efavirenz and nevirapine after interrupting treatment was much higher (21%) than in first-time users (8%).
        People living with HIV might go on and off the drugs for several reasons. Stigma plays a huge part, says Bertagnolio; they might not want to be seen picking up their medicine. Drug shortages at clinics could also contribute, the report noted.
        In response to the evidence, the WHO has recommended that countries use dolutegravir, which is more effective and tolerable than other therapies, as the go-to HIV drug. The likelihood that the virus will develop mutation and, eventually, resistance is lower with dolutegravir than with other antiretrovirals, says Roger Paredes, an infectious-disease physician at the Germans Trias i Pujol University Hospital in Barcelona, Spain. "We have to encourage a worldwide transition to dolutegravir," he adds.
What is the reason why people stop using drugs to treat HIV?
选项 A、Because of the prevalence of resistance in drugs.
B、Because the therapies of HIV are not effective and tolerable.
C、Because most people don’t have the money to pay for expensive HIV drugs.
D、Because they believe it is a mark of shame and discredit to continue the drugs.
答案D
解析 细节题：题干：人们停止使用药物治疗艾滋病的原因是什么?本题的关键词是“reason”“stop using drugs”，根据题干关键词定位到文章倒数第二段“People living with HIV might go on and off the drugs for several reasons. Stigma plays a huge part，says Bertagnolio；they might not want to be seen picking up their medicine. Drug shortages at clinics could also contribute，the report noted.(患艾滋病的人时断时续地使用药物的原因有很多。Bertagnolio说羞耻是其中重要的一个原因；他们不想被人看到还在吃药。报告中提到，诊所的药物短缺也是原因之一)”。由此可知，艾滋病患者中断药物的原因有两个，一是他们自己觉得羞耻，二是诊所的药物短缺，所以D项“因为他们认为继续使用药物是一种耻辱”符合原文，故本题选D。A项“因为药物普遍存在耐药性”，B项“因为艾滋病的治疗是无效的和不能忍受的”，C项“因为大多数人没有钱购买昂贵的艾滋病药物”在文章中均未提及。
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