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
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
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）
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
需考虑的检查
- 如果出现 HIV 血清转换症状，检测 HIV 病毒载量
治疗流程
≥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 consulting fees from Thriva Ltd. and conference reimbursement 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.
指南
- 预防 HIV 感染的 PEP
- 欧洲 HIV 携带者管理指南
更多 指南患者教育信息
丙型肝炎：何为丙型肝炎？
HIV：高风险人群的预防治疗（PrEP）
更多 患者教育信息
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