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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  19
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 does the passage mainly talk about?
选项 A、Authorities try to find effective and tolerable therapies to treat HIV.
B、Authorities have discovered the causes of resistance to crucial HIV drugs.
C、WHO conducted surveys to examine the levels of resistance in people who had started HIV treatment.
D、Authorities have uncovered an alarming surge in resistance to crucial HIV drugs.
答案D
解析 主旨题。题干：这篇文章主要讲了什么?文章开头就指出世界卫生组织调查显示，在过去的4年间，在非洲、亚洲和美洲的12个国家，对依法韦伦、奈韦拉平这两种主要治疗艾滋病的药物产生耐药性的人数已经超过了可以接受的水平。后文主要是围绕这个调查展开的，展示了一部分数据、讲了耐药性产生的原因、中断治疗的原因、可以替代的药物等。总体来看，文章围绕此项研究展开，所以本文主旨即世界卫生组织经调查发现，对艾滋病的主要治疗药物产生耐药性的人数激增，故D项“官方揭露对艾滋病主要治疗药物产生耐药性的人数激增”最能概括全文。A项“官方尝试寻找有效、且更耐受的药物治疗艾滋病”，文章最后虽然提到世界卫生组织推荐使用度鲁特韦这种药物，但是这不是本文的重点，所以A项不是文章主旨；B项“官方发现了对主要艾滋病治疗药物产生耐药性的原因”，文中说这一原因并没有确定，故B项排除；C项“世界卫生组织调查了进行艾滋病治疗的患者的耐药性水平”，虽然这是研究的主要内容，但是并没有揭示研究的结果，故排除。故本题选D。
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