HIV 暴露后预防

最后审阅: 6 一月 2023
最后更新: 15 七月 2022

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 在过去 72 小时内暴露于 HIV
  • 安全套破裂、脱落或未使用
  • 源患者的射精史
  • 外伤或皮肤破损
  • 生殖器溃疡
  • 源患者来自 HIV 病毒血症高风险人群
  • 来自 HIV 高流行率地区的源患者
  • 已暴露人员的高危性生活史
  • 在源患者中可检测到 HIV 病毒载量
更多 关键诊断因素

其他诊断因素

  • 源患者的 HIV 检测阴性既往史
  • 合并肝炎感染的源患者
  • 源患者中 HIV 对抗病毒药物的耐药性
  • 正在使用的处方或非处方药物
  • 药物过敏史
  • 流感样疾病
其他诊断因素

危险因素

  • 来自 HIV 阳性供者的输血
  • 共用注射器具
  • 针头刺伤
  • 肛交的被动方
  • 阴道性交的被动方
  • 粘膜暴露
  • 肛交的主动方
  • 阴道性交的主动方
  • 口交的被动方(吮吸阴茎)
更多 危险因素

诊断性检查

首要检查

  • HIV 抗原/抗体血液检测(血液 ELISA 或 EIA)
  • 快速 HIV 即时检测(POCT)
  • 肾功能检查
  • 肝功能检查(LFT)
  • 乙型肝炎血清学检查
  • 丙型肝炎抗体
  • 梅毒血清学检查
  • 妊娠试验
  • 筛查其他 STI
更多 首要检查

需考虑的检查

  • 如果出现 HIV 血清转换症状,检测 HIV 病毒载量
更多 需考虑的检查

治疗流程

急症处理

≥13 岁的成人或青少年:非妊娠

妊娠或母乳喂养妇女

儿童

撰稿人

作者

Ming Jie Lee, BSc(Hons), MBBS, MRCP

Clinical Research Fellow

Department of Infectious Disease

Imperial College London

London

UK

利益声明

MJL has received honoraria and travel grants from Gilead Sciences, Inc., and travel grants from ViiV Healthcare, not related to this work.

Julie Fox, BSc(Hons), MBChB, MRCP, MD

HIV consultant and Honorary Senior Lecturer KCL

Department of HIV

Harrison Wing

Guy’s and St Thomas Hospital NHS Foundation Trust

London

UK

利益声明

JF declares that she has no competing interests.

鸣谢

Dr Ming Jie Lee and Dr Julie Fox would like to gratefully acknowledge Dr Jennifer A. Johnson, Dr Paul Sax, Dr Rebecca Plank, Dr Michael Brady, Dr Emily Cheserem, and Dr Claire M. Naftalin, the previous contributors to this topic.

利益声明

JAJ declares that she has no competing interests. PS serves as a consultant for Abbott, BMS, Gilead, GSK, Merck, and Janssen. He receives grant support from BMS, Gilead, and GSK. EC has been sponsored by GlaxoSmithKline for several conferences and sponsored by Gilead Sciences, Bristol-Myers Squibb Pharmaceuticals, and Abbott Laboratories to attend various educational programs. CMN has been sponsored by Bristol-Myers Squibb Pharmaceuticals to attend an educational program. CMN is an author of a reference cited in this topic. MB not disclosed. RP declares that she has no competing interests.

同行评议者

Professor Margaret Johnson, MB BS, MD, FRCP

Clinical Director

HIV/AIDS Services

Royal Free Hampstead NHS Trust

London

UK

利益声明

MJ declares that she has no competing interests.

William Rodriguez, MD

Chief Medical Officer

Foundation for Innovative New Diagnostics (FIND)

Campus Biotech

Geneva

Switzerland

利益声明

Not disclosed.

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