《中国艾滋病诊疗指南(2024版)》解读  

Interpretation of guidelines for diagnosis and treatment of HIV/AIDS in China(2024 Edition)

作　　者：沈银忠 李太生[2] SHEN Yinzhong;LI Taisheng(Department of Infection and Immunity,Shanghai Public Health Clinical Center,Fudan University,Shanghai 201508,China;不详)

机构地区：[1]复旦大学附属公共卫生临床中心感染与免疫科,上海201508 [2]中国医学科学院北京协和医院感染内科,北京100730

出　　处：《中国预防医学杂志》2025年第2期129-132,共4页Chinese Preventive Medicine

基　　金：上海市科技计划项目(21Y31900400);上海申康医院发展中心市级医院诊疗技术推广及优化管理项目(SHDC22024317)。

摘　　要：基于我国临床实践和中国人群相关研究数据,结合国际最新研究成果,中华医学会感染病学分会艾滋病学组和中国疾病预防控制中心联合发布了《中国艾滋病诊疗指南(2024版)》(以下简称《指南》)。2024版《指南》重点对抗病毒治疗(antiretroviral therapy,ART)、机会性感染、人类免疫缺陷病毒(human immunodeficiency virus,HIV)合并肿瘤、HIV感染的预防与干预、全程管理等内容进行了更新;首次把国产单片制剂写入首选ART方案中;首次推荐新确诊HIV感染者或使用长效卡替拉韦(CAB-LA)进行暴露前预防(pre-exposure prophylaxis,PrEP)后仍感染HIV的患者,如考虑存在HIV对整合酶抑制剂耐药,则应进行整合酶基因突变检测;首次将低病毒载量的概念和规范处理写入《指南》;新增“艾滋病免疫功能重建不全”内容,首次提出了“艾滋病脆弱人群”的概念;更新了HIV全程管理的五个方面的内容,针对HIV感染的核酸诊断标准,明确了1000拷贝/ml的阈值;强调对HIV患者各种慢性病,包括心血管疾病和非艾滋病定义性肿瘤等的筛查、规范诊治和预防的重要性。《指南》丰富了艾滋病诊疗理论与实践体系,增加了诊治推荐意见、推荐证据和推荐强度,体现了我国在艾滋病临床和基础研究方面的进展。The"Guidelines for diagnosis and treatment of AIDS in China(2024 Edition)"was updated and revised based on China's clinical practices,research data related to the Chinese population,and the international latest research findings,building upon the previous five editions.The 2024 edition focuses on updating content related to antiretroviral therapy(ART),opportunistic infections,human immunodeficiency virus(HIV)associated tumors,prevention and intervention strategies for HIV infection,and comprehensive management.Notably,it is the first time that domestically produced single-tablet regimens have been included in the preferred ART options.The guidelines also recommend that newly diagnosed HIV-infected individuals or those who have received long-acting cabotegravir(CAB-LA)for pre-exposure prophylaxis(PrEP)and subsequently test positive for HIV should undergo integrase gene mutation testing if there is a concern for resistance to integrase strand transfer inhibitors(INSTIs).Additionally,the concept and standardized management of low viral load has been included in the guidelines for the first time.The new content introduces the concept of"Incomplete Immune Reconstitution in AIDS"and proposes the notion of"Vulnerable Populations in AIDS".The guidelines update five aspects of comprehensive HIV management,clarifying the nucleic acid diagnostic criteria for HIV infection with a threshold of 1000 copies/ml.They emphasize the importance of screening,standardized treatment,and prevention for various chronic diseases among HIV patients,including cardiovascular diseases and non-AIDS-defining tumors.Overall,the Guidelines enrich the theoretical and practical framework for HIV/AIDS diagnosis and treatment,enhancing recommendations,supporting evidence,and strength of recommendation,reflecting advancements in clinical and fundamental research on HIV/AIDS in China.

关 键 词：获得性免疫缺陷综合征 人类免疫缺陷病毒 诊断 治疗 指南 解读 

分 类 号：R512.91[医药卫生—内科学]