解决HIV感染者晚发现的策略:以综合性医院为中心开展全病程管理治疗  

Addressing the challenge of late presentation of HIV infection:recommendations for comprehensive management of HIV infection in general hospitals

作　　者：林铃[1] 李太生[1,2,3] Lin Ling;Li Taisheng(Department of Infectious Diseases,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China;Center for AIDS Research,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China;Tsinghua-Peking Center for Life Sciences,School of Medicine,Tsinghua University,Beijing 100084,China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院感染内科,100730 [2]中国医学科学院北京协和医学院艾滋病研究中心,100730 [3]清华大学医学院生命科学院,北京100084

出　　处：《国际流行病学传染病学杂志》2021年第3期171-175,共5页International Journal of Epidemiology and Infectious Disease

摘　　要：HIV/AIDS已由不治之症逐渐转变为内科慢性疾病,但仍有1/3左右的患者诊断较晚。晚发现感染者具有较高的住院率和传播风险、较重的经济负担和较差的远期预后,故HIV感染晚发现是我国目前防治艾滋病的重要挑战之一。非高危人群筛查范围有限、临床医护人员对HIV感染者非特异性症状的识别不足、男男性行为HIV感染者循环重组株01_AE亚型比例较高导致疾病进展快是我国HIV感染者晚发现的重要原因。目前HIV/AIDS的诊疗重心已逐渐转移至综合性医院,提高综合性医院临床医疗人员对HIV感染后非特异性症状的识别、扩大对患者各种复杂的机会性感染及合并症的认知、重视手术及其他侵入性操作前HIV抗体筛查或将有效降低晚发现比例。以综合性医院为艾滋病临床诊疗中心,结合CDC以及传染病院三架马车并进或将成为未来HIV/AIDS防治工作的重要形式。HIV/AIDS has gradually changed from an incurable disease to an internal chronic disease,but about 1/3 of the patients are still diagnosed late.Late presentation is associated with high hospitalization rate,high transmission risk,heavy economic burden and poor long-term prognosis.Therefore,late presentation is one of the important challenges in the prevention and treatment of AIDS in China.The important reasons for the late presentation in China are the limited screening scope of non-high-risk population,the insufficient recognition of non-specific symptoms of HIV infection,and the high proportion of circulating recombinant form 01_AE subtype in HIV patients with male homosexual behavior.The focus of the diagnosis and treatment of HIV/AIDS has gradually shifted to general hospitals,and the late presentation rate may be effectively reduced by improving the recognition of non-specific symptoms of HIV infection,expanding the cognition of patients with various complex opportunistic infections and complications,and paying attention to HIV antibody screening before surgery and other invasive procedures in general hospitals.Taking the general hospital as the AIDS clinical diagnosis and treatment center,combining the Centers for Disease Control and Prevention and the infectious disease hospital may become an essential form of HIV/AIDS prevention and treatment in the future.

关 键 词：HIV 艾滋病 晚发现 全病程管理 综合性医院 策略 

分 类 号：R512.91[医药卫生—内科学]