急性HIV感染诊疗管理专家共识(2025版)  

Expert consensus on the diagnosis and treatment of acute HIV infection(2025)

作　　者：中国性病艾滋病防治协会艾滋病药物预防与阻断专委会 国家感染病临床研究中心 深圳市第三人民医院(南方科技大学第二附属医院) 张秋月 张路坤[2] 何云[2] Chinese Association of STD&AIDS Prevention and Control;National Clinical Research Center for Infectious Diseases;Shenzhen Third People’s Hospital(The Second Affiliated Hospital of Southern University of Science and Technology);HE Yun

机构地区：[1]不详 [2]深圳市第三人民医院(南方科技大学第二附属医院)

出　　处：《中国艾滋病性病》2025年第3期226-235,共10页Chinese Journal of Aids & STD

基　　金：中国国家重点研发计划(No.2023YFC2306700);深圳市第三人民医院院内课题(No.21250G1001;No.22250G1013;No.22240G1005;No.XKJS-CRGRK-008);广东省高水平临床重点专科(SZCSP011)。

摘　　要：当前HIV流行形势依然严峻,研究显示约50%的经性传播感染者都是与急性期或早期HIV感染者发生性行为暴露所致。HIV感染早期,病毒大量扩增,病毒储存库建立,此时期是通过治疗和干预控制HIV病毒复制、最大限度保护免疫功能及抑制全身免疫激活的关键时期。因此,无论对于公共卫生,还是感染者的临床预后及全病程管理,急性HIV感染者的早期识别、治疗管理及健康教育都极为重要。然而,急性HIV感染的筛查与诊断仍存在较大挑战。2022年,中国性病艾滋病防治协会(简称中艾协)艾滋病药物预防与阻断专委会组织领域内专家,制定了《HIV急性感染期诊疗管理专家共识》(以下简称“2022版共识”),旨在为我国成人急性HIV感染的诊疗提供循证医学建议。本共识在“2022版共识”基础上,综合国内外研究进展及我国临床实践进行更新,强调了“扩大筛查、多学科参与、尽早诊断”的重要性,对急性感染者的筛查、诊断、cART及感染者健康教育提出了更为详细的推荐意见,以期进一步提高我国急性HIV感染者的临床管理能力,降低HIV新发感染。The current situation of the HIV epidemic remains critical.Research has shown that approximately 50%of sexually transmitted HIV cases result from exposure to individuals with acute or early HIV infections through sexual contact.During the early stage of HIV infection,massive viral replication occurs,and a viral reservoir is established.This represents a critical period for controlling HIV replication,maximally protecting immune function,and preventing systemic immune activation through treatment and intervention.Therefore,early identification of patients with acute HIV infection and their treatment,management,and health education are of vital importance,both from a public health perspective and for the clinical prognosis of infected individuals and integrated disease management.However,substantial challenges remain in screening and diagnosing acute HIV infections.In 2022,the Chinese Association of STD&AIDS Prevention and Control organized a group of experts in the field to develop the Expert Consensus on the Diagnosis and Treatment of Acute HIV Infections("Consensus 2022")with the aim of providing evidence-based medical recommendations for the diagnosis and treatment of adult acute HIV infections in China.The current consensus builds upon Consensus 2022and provides updates by synthesizing domestic and international research progress as well as clinical practice in China.This updated consensus emphasizes the importance of screening scale-up,multidisciplinary involvement,and early diagnosis,and provides more detailed recommendations regarding the screening,diagnosis,combination antiretroviral therapy(cART),and health education of individuals with acute HIV infections,with the hope of further raising the clinical management capability for individuals with acute HIV infections in China and reducing incident HIV infections.

关 键 词：艾滋病病毒 急性感染 诊断 管理 抗病毒治疗 

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