晚发现艾滋病病毒感染临床管理专家共识  

Expert consensus on the clinical management of HIV late presentation

作　　者：吕玮[1] 蔡卫平[2] 陈耀凯[3] 韩孟杰[4] 何云[5] 李惠琴 李凌华[2] 卢瑞朝 马萍[8] 孙丽君[9] 孙永涛 王辉[5] 王汝刚 汪宁[4] 魏洪霞[12] 张彤[9] 赵红心[13] 赵清霞 周莹荃 张福杰[13] 李太生[1] LYU Wei;CAI Weiping;CHEN Yaokai;HAN Mengjie;HE Yun;LI Huiqin;LI Linghua;LU Ruichao;MA Ping;SUN Lijun;SUN Yongtao;WANG Hui;WANG Rugang;WANG Ning;WEI Hongxia;ZHANG Tong;ZHAO Hongxin;ZHAO Qingxia;ZHOU Yingquan;ZHANG Fujie;LI Taisheng(Chinese Academy of Medical Science,Peking Union Medical College,Peking Union Medical College Hospital,Beijing 100730,China;Guangzhou Eighth People's Hospital,Guangzhou 510440,Guangdong,China;Chongqing Public Health Medical Center,Chongqing 400030,China;Chinese Center for Disease Control and Prevention,Beijing 102206,China;Shenzhen Third People's Hospital(The Second Affiliated Hospital of Southern University of Science and Technology),Shenzhen 518112,Guangdong,China;Yunnan Provincial Hospital of Infectious Disease,Kunming 650301,Yunnan,China;Liuzhou Longtan Hospital of Guangxi Zhuang Autonomous Region,Liuzhou 545026,Guangxi,China;Tianjin Second People's Hospital,Tianjin 300192,China;Beijing You'an Hospital,Capital Medical University,Beijing 100069,China;Tangdu Hospital,Air Force Medical University,Xi'an 710032,Shanxi,China;Dalian Public Health Clinical Center,Dalian 116037,Liaoning,China;The Second Hospital of Nanjing,Nanjing 210037,Jiangsu,China;Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Henan Infectious Diseases Hospital,Zhengzhou 450015,Henan,China;Lanzhou Pulmonary Hospital,Lanzhou 730071,Gansu,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,北京100730 [2]广州市第八人民医院,广州510440 [3]重庆市公共卫生医疗救治中心,重庆400030 [4]中国疾病预防控制中心,北京102206 [5]深圳市第三人民医院(南方科技大学第二附属医院),广东深圳518112 [6]云南省传染病医院,昆明650301 [7]广西柳州龙潭医院,广西柳州545026 [8]天津市第二人民医院,天津300192 [9]首都医科大学附属北京佑安医院,北京100069 [10]空军军医大学唐都医院,西安710032 [11]大连市公共卫生临床中心,辽宁大连116037 [12]南京市第二医院,南京210037 [13]首都医科大学附属北京地坛医院,北京100015 [14]河南省传染病医院,郑州450015 [15]兰州市肺科医院,兰州730071

出　　处：《中国艾滋病性病》2024年第7期670-682,共13页Chinese Journal of Aids & STD

基　　金：北京协和医院中央高水平医院临研专项(2022-PUMCH-D-008)。

摘　　要：随着联合抗反转录病毒治疗(combination antiretroviral therapy,cART)的进步,全球艾滋病病毒(HIV)新发感染及相关死亡人数已显著下降,但“晚发现”(late presentation,即就诊时伴低CD4细胞计数或艾滋病定义性事件)HIV感染者比例高仍是艾滋病防治的重要挑战之一。晚发现HIV感染者临床风险高、管理复杂,且具有较高的传播风险,对达成“三个95%”及终结艾滋病流行目标造成较大挑战。然而,目前国内外均缺乏专门针对这一人群的临床管理规范。因此,中国人体健康科技促进会免疫缺陷监测与转化专业委员会组织领域内专家,根据近年来国内外最新研究证据和临床实践经验,探讨晚发现HIV感染者的定义、临床特征和风险,以及抗病毒治疗策略等临床管理问题,并制定具体推荐意见,旨在为临床工作者提供参考。With the advancement of combination antiretroviral therapy(cART),the global number of new HIV infections and HIV-related mortality has significantly declined.However,the high proportion of"late presentation"(defined as presenting to care with a low CD4 cell count or AIDS-defining events)among HIV-infected individuals remains a significant challenge in HIV prevention and treatment.HIV late presentation is associated with increased clinical risk,complex management,and higher risk of transmission,and represents a significant barrier to achieving the"95-95-95"targets and ending the HIV epidemic.Currently,both nationally and internationally,there is a lack of specific clinical guidelines for this population.Therefore,the China Association for Promotion of Health Science and Technology convened experts in the field to discuss the definition,clinical characteristics,risks,and cART of late presenters based on the latest research evidence and clinical practices both domestically and internationally.Specific recommendations were formulated to guide healthcare professionals in their clinical practice.

关 键 词：晚发现 艾滋病病毒 抗病毒治疗 快速启动 临床管理 

分 类 号：R512.91[医药卫生—内科学] R373.9[医药卫生—临床医学]