最近审阅: 27 一月 2021
最近更新: 04 三月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 发热和盗汗
  • 体重减轻
  • 皮疹和炎症后瘢痕
  • 口腔溃疡、口角炎、鹅口疮或口腔毛状白斑
  • 腹泻
  • 消耗综合征
  • 精神状态或神经精神功能改变
  • 最近住院
  • 结核病 (TB)
  • 医学共病
  • 性活动
  • 全身性淋巴结肿大
  • Kaposi 肉瘤
  • 生殖道 STI
  • 慢性阴道念珠菌病
  • 带状疱疹
  • 各类头痛
  • 牙周病
  • 视网膜病变(眼底镜)
  • 活动时气短、活动时发绀、干咳、肺部听诊为寂静胸

其他诊断因素

  • 当前和既往使用其他药物
  • 周围神经病
  • 复发性单纯疱疹
  • 肝或脾大
  • 脑膜炎体征(细菌或病毒性脑膜炎)

危险因素

  • 静脉注射毒品时共用针头
  • 无保护肛交接受方
  • 无保护阴茎-阴道性交接受方
  • 经皮针刺伤
  • 母体病毒载量高(母婴传播)
  • 使用仅含孕激素的注射型避孕药
  • 2 型单纯疱疹病毒 (herpes simplex virus type 2, HSV-2) 感染

诊断性检查

首要检查

  • 血清 HIV 酶联免疫吸附测定 (ELISA)
  • 血清 HIV 快速检测
  • 无创 HIV 检测
  • 血清蛋白免疫印迹法
  • 血清 p24 抗原
  • 血清 HIV DNA 聚合酶链反应 (PCR)
  • CD4 细胞计数
  • 血清病毒载量 (HIV RNA)
  • 耐药检测
  • 妊娠试验
  • 乙型肝炎病毒血清学检测
  • 丙型肝炎病毒血清学检查
  • 血清性病研究实验室试验
  • 梅毒螺旋体血凝试验
  • 快速血浆反应素试验
  • 结核菌素皮肤试验
  • FBC 和分类计数
  • 血清电解质
  • 血清肌酐
  • 尿液分析

需考虑的检查

  • 胸部 X 线检查
  • 肝功能检查 (LFTs)
  • 随机或空腹血脂
  • 随机或空腹血糖
  • 甲型肝炎血清检测 (IgG)
  • 弓形虫血清学检查 (IgG)
  • 淋病和衣原体检测
  • 人类白细胞抗原-B*5701 检测

治疗流程

撰稿人

Assistant Professor of Medicine

Infectious Diseases

Northwestern Medicine

Feinberg School of Medicine, Northwestern University

Chicago

IL

利益声明

CJA is a consultant on an educational programme on HIV and ageing with ViiV, has received speaker fees for talks on HIV and ageing with ViiV, and has received a grant for investigator sponsored research from Gilead Sciences.

Dr Chad J. Achenbach would like to gratefully acknowledge Dr Richard Rothman, Dr Michael Ehmann, Dr Linda-Gail Bekker, Dr Catherine Orrell, and Dr Lisa Capaldini, the previous contributors to this topic.

利益声明

ME, LGB, and CO declare that they have no competing interests. RR attended a symposium/conference hosted by a funding agency, Gilead HIV FOCUS programme, from which he receives research funds. RR pays staff for an implementation/research programme grant from Gilead HIV FOCUS for development of HIV testing programmes in Emergency Departments. LC is on the speakers' bureau for the following pharmaceutical companies: GlaxoSmithKline, BMS, Merck, Gilead, Roche, Pfizer, Solvay, Lilly, Serrano, and Tibotec.

同行评议者展开全部内容

Clinical Assistant Professor

University of British Columbia

Vancouver

Canada

利益声明

MH is a member of an advisory board and/or speakers' bureau for Gilead Sciences Canada Inc, Merck Canada Inc, and ViiV Healthcare.

Assistant Professor of Medicine

Harvard Medical School

Director of Research

Global Health Delivery Project

Harvard School of Public Health

Boston

MA

利益声明

WR declares that he has no competing interests.

Infectious Disease Physician

Oxford University Clinical Research Unit

Hospital for Tropical Diseases

Ho Chi Minh City

Vietnam

利益声明

JD declares that he has no competing interests.

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