Lyrics · 完整歌詞
Effective treatment alone does not ensure control of tuberculosis,
HIV or viral hepatitis; outcomes also depend on diagnosis, access,
continuity of care and support for sustained treatment.
Tuberculosis tests whether treatment is completed,
HIV tests whether the fearful will come forward,
and hepatitis tests whether a vaccine
and a short course can rewrite a generation's cancer risk.
Treatment failure in tuberculosis is usually a failure of duration rather than potency.
Two months of isoniazid, rifampicin,
pyrazinamide and ethambutol are followed by four months of isoniazid and rifampicin.
However, symptoms often settle within three or four weeks,
and patients who stop at that point leave behind the bacilli that
were hardest to kill.
Multidrug-resistant tuberculosis is thus selected by interrupted therapy,
not created by an unusual host.
Directly observed therapy exists for precisely this reason,
because it transfers responsibility for completion from the patient to the health system.
Effective treatment alone does not ensure control of tuberculosis,
HIV or viral hepatitis; outcomes also depend on diagnosis, access,
continuity of care and support for sustained treatment.
Latent infection is the second battlefield.
A person with latent tuberculosis is not ill, is not infectious,
has a normal chest radiograph and a negative sputum culture.
Yet roughly one in ten will develop active disease during their lifetime,
and far more will do so if immunity fails.
Treating latency therefore defuses a future source of transmission rather than curing a present
disease.
The interferon-gamma release assay uses ESAT-6 and CFP-10,
antigens encoded in the RD1 region deleted from BCG.
Consequently,
prior vaccination causes false-positive tuberculin skin tests but leaves the assay unaffected.
Shorter regimens such as twelve weekly doses of isoniazid
and rifapentine raise completion.
HIV control is limited less by pharmacology than by fear,
since undiagnosed people neither take treatment nor protect their partners.
Anonymous testing lowers the psychological threshold,
and sustained viral suppression means the virus is not transmitted sexually.
Pre-exposure prophylaxis protects the uninfected,
but it must never be started before infection is excluded.
A partial regimen given during the acute window selects resistant virus,
and early infection is detected only by RNA or p24 antigen.
Post-exposure prophylaxis must begin within seventy-two hours and continue for four weeks.
Hepatitis B is decided at birth,
because the younger the age at infection,
the higher the chance of chronic carriage.
Around ninety per cent of infected infants become carriers as their tolerant
immune systems accept the virus as self.
A first vaccine dose within twenty-four hours,
with immunoglobulin when the mother is infectious, interrupts transmission before tolerance forms.
Universal infant vaccination lowered childhood carriage from about ten per cent to below one
per cent
and reduced childhood hepatocellular carcinoma.
Hepatitis C has no vaccine, because its envelope proteins mutate too quickly,
but direct-acting antivirals cure more than ninety-five per cent within eight to twelve weeks.
Effective treatment alone does not ensure control of tuberculosis,
HIV or viral hepatitis; outcomes also depend on diagnosis, access,
continuity of care and support for sustained treatment.