Acquired immunodeficiency syndrome

获得性免疫缺陷综合征
  • 文章类型: Journal Article
    背景:欧洲艾滋病临床学会(EACS)指南于2023年进行了第19次修订,和艾滋病毒护理的所有方面都更新了。
    该指南的12.0版推荐了与11.0版和11.1版相同的抗逆转录病毒治疗(ART)初治成人的六种一线治疗选择:基于替诺福韦的骨架加上未增强的整合酶抑制剂或doravirine;阿巴卡韦/拉米夫定加多卢特韦;或拉米夫定或恩曲他滨加劳韦的双重治疗。长效部分已在ART和药物-药物相互作用(DDI)面板中扩展。儿童和青少年首选和替代ART的表格已经更新,关于防止垂直传播的部分也是如此,特别是关于母乳喂养的新指南。一个新的DDI表已经包括了用于机会性感染的ART和抗感染药物,性传播感染,和其他传染病;列那卡巴韦已被包括在所有DDI表中。关于酒精使用和患者报告结果测量(PROM)的新部分已被纳入合并症小组,除了许多相关主题的更新之外,如新的资源指导对艾滋病毒感染者开处方。其他部分,包括旅行,认知障碍,癌症筛查,性健康,和糖尿病也被广泛修订。用于管理急性丙型肝炎病毒感染的算法已被删除,目前的指南建议立即治疗所有最近获得丙型肝炎病毒的人。提供了乙型肝炎病毒疫苗接种的更新以及在具有分离的抗乙型肝炎核心抗体的人中简化为无替诺福韦的两种药物方案的建议。在机会性感染和COVID-19组中,根据最新证据,对艾滋病病毒感染者中COVID-19的管理指南进行了更新,并且添加了有关猴痘的新部分。
    结论:在2023年,EACS指南进行了广泛更新,现在包括了几个新的部分。这些建议可以作为一个免费的应用程序,以交互式Web格式,作为一个PDF在线。
    The European AIDS Clinical Society (EACS) guidelines were revised in 2023 for the 19th time, and all aspects of HIV care were updated.
    Version 12.0 of the guidelines recommend the same six first-line treatment options for antiretroviral treatment (ART)-naïve adults as versions 11.0 and 11.1: tenofovir-based backbone plus an unboosted integrase inhibitor or doravirine; abacavir/lamivudine plus dolutegravir; or dual therapy with lamivudine or emtricitabine plus dolutegravir. The long-acting section has been expanded in the ART and drug-drug interaction (DDI) panels. Tables for preferred and alternative ART in children and adolescents have been updated, as has the section on prevention of vertical transmission, particularly with new guidance for breastfeeding. A new DDI table has been included for the ART and anti-infective drugs used for opportunistic infections, sexually transmitted infections, and other infectious conditions; lenacapavir has been included in all DDI tables. New sections on alcohol use and patient-reported outcome measures (PROMs) have been included in the comorbidity panel, in addition to updates on many relevant topics, such as new resource guidance for deprescribing in people with HIV. Other sections, including travel, cognitive impairment, cancer screening, sexual health, and diabetes have also been revised extensively. The algorithm for the management of acute hepatitis C virus infection has been removed, as current guidelines recommend immediate treatment of all people with recently acquired hepatitis C virus. Updates on vaccination for hepatitis B virus and recommendations for simplification to tenofovir-free two-drug regimens in people with isolated anti-hepatitis B core antibodies are provided. In the opportunistic infections and COVID-19 panel, guidance on the management of COVID-19 in people with HIV has been updated according to the most up-to-date evidence, and a new section on monkeypox has been added.
    In 2023, the EACS guidelines were updated extensively and now include several new sections. The recommendations are available as a free app, in interactive web format, and as a pdf online.
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  • 文章类型: Journal Article
    背景:比较中国2006年、2011年、2015年和2018年HIV/AIDS患者4种治疗起始时间的生存率,并探讨影响生存时间的因素。
    方法:于2006年4月至2020年12月在柳州市进行HIV/AIDS感染者回顾性队列研究。该信息是从国家艾滋病综合预防和控制信息系统获得的。使用生命表和Kaplan-Meier方法计算参与者的生存率和时间。采用单因素和多因素Cox回归模型探讨与生存相关的因素。
    结果:18,543名参与者被纳入本研究。在四个时期,1年生存率为81%,87%,95%,和95%。2年生存率为76%,85%,93%,94%。3年生存率为73%,84%,92%,94%。多变量Cox回归结果显示,艾滋病毒诊断的年龄,种族,户籍,职业,婚姻状况,治疗的时机,教育水平,艾滋病毒传播途径,是否接受抗逆转录病毒治疗(ART),基线时的CD4+T细胞计数(HIV诊断时的CD4+T细胞计数)是与HIV感染引起的死亡率显着相关的因素。
    结论:随着指南从2006年到2020年的更新,1-,2-,在四个时期内,艾滋病毒/艾滋病感染者的3年生存率呈上升趋势。艾滋病诊断和治疗指南(指南)的更新版本的治疗开始时间显着延长了艾滋病毒/艾滋病感染者的生存时间。
    To compare the survival rates of four timing of treatment initiation for people living with HIV/AIDS provided in China in 2006, 2011, 2015, and 2018, and to investigate the factors impacting survival time.
    A people living with HIV/AIDS retrospective cohort study was in Liuzhou City from April 2006 to December 2020. The information was obtained from the National Comprehensive AIDS Prevention and Control Information System. Life tables and the Kaplan-Meier method were used to calculate participant survival rates and time. The univariate and multivariate Cox regression models were used to investigate the factors related to survival.
    18,543 participants were included in this study. In four periods, the 1-year survival rates were 81%, 87%, 95%, and 95%. The 2-year survival rates were 76%, 85%, 93%, and 94%. The 3-year survival rates were 73%, 84%, 92%, and 94%. Results of multivariate Cox regression showed that sex, age of HIV diagnosis, ethnicity, household registration, occupation, marital status, the timing of treatment, education level, route of HIV transmission, whether receiving antiretroviral therapy (ART), and the count of CD4+T cells at baseline (count of CD4+T cells at HIV diagnosis) were factors that are significantly correlated with mortality caused by HIV infection.
    With the Guidelines updated from 2006 to 2020, the 1-, 2-, and 3-year survival rates of people living with HIV/AIDS in four periods tended to increase. The timing of treatment initiation of the updated edition of the AIDS Diagnostic and Treatment Guidelines (Guidelines) significantly prolonged the survival time of people living with HIV/AIDS.
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  • 文章类型: English Abstract
    Human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) are one of the global public health issues concerning health of human beings. Dyslipidemia is one of the major risk factors for cardiovascular events, while elevation of plasma cholesterol levels is associated with the onset of over 50% coronary heart disease. The incidence risks of cardiovascular diseases are higher in HIV/AIDS patients than those in normal populations. In addition to conventional risk factors, viral duplication and suboptimal treatments increase risks of atherosclerotic coronary vascular disease (ASCVD) in HIV/AIDS patients. Thus, a deep knowledge of lipid metabolism and dysregulation profiles, an efficient control of conventional ASCVD risk factors, as well as strengthened measures to lipid management, are of significance to improve long-term prognosis and life quality for HIV/AIDS patients. However, up to date, there is no particular consensus on lipid management for HIV/ADIS populations under long-term antiretroviral therapies (ART). Hereby, based on current status quo of ART in China and frontier achievements of fundamental researches and clinical trials, we invited domestic experts in fields of infectious diseases and cardiovascular diseases to compose this expert consensus on the integrated management of lipid in HIV/AIDS patients in China.
    人类免疫缺陷病毒(HIV)感染和获得性免疫缺陷综合征(AIDS)是影响人类健康的全球性公共卫生问题之一。血脂异常是心血管事件发生的主要危险因素,胆固醇水平升高与全球超过50%的冠心病发病相关。HIV/AIDS患者的心血管疾病风险高于一般人群,除了传统风险因素以外,HIV病毒复制和抗病毒治疗不良反应等因素均增加了动脉粥样硬化性心血管疾病(ASCVD)风险。深入认识HIV/AIDS患者群体血脂代谢特征和变化规律,积极控制ASCVD传统风险因素,强化患者血脂异常管理,对降低ASCVD发生风险,改善患者远期预后和生活质量都具有重要意义。目前,我国尚无针对艾滋病的专家共识指导接受长期抗反转录病毒治疗(ART)的HIV/AIDS患者的血脂管理。基于这一现状,我们邀请国内感染病学和心血管疾病领域的专家,结合我国抗病毒治疗实际和前沿基础/临床研究成果,共同编写HIV/AIDS患者血脂综合管理中国专家共识。.
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  • 文章类型: Journal Article
    南非少女意外怀孕和包括艾滋病毒在内的性传播感染的发生率很高。为文化上量身定制的双重保护干预措施提供信息,以防止意外怀孕和性传播感染/艾滋病毒,这项研究定性地检查了女孩的性健康干预偏好。参与者年龄为14-17岁,讲塞索托语(N=25)。为了阐明共同的文化信仰,个别访谈检查了参与者对其他少女怀孕的看法和性传播感染/艾滋病毒预防干预的偏好。面试在塞索托进行,并翻译成英文。两个独立的编码器使用传统的内容分析方法确定了数据中的关键主题,差异由第三个编码器解决。参与者指出,干预内容应包括有效的怀孕和性传播感染/艾滋病毒预防方法以及应对同伴压力的方法。干预措施应该是可以获得的,避免批评,提供高质量的信息。首选的干预形式包括在线,SMS/text,或由社会工作者或更年长的人交付,知识渊博的同龄人,父母或同龄同龄人对分娩的接受度参差不齐。学校,青年中心和性健康诊所是首选的干预机构.结果强调了文化背景在调整双重保护干预措施以解决南非少女生殖健康差距方面的重要性。
    South African adolescent girls experience high rates of unintended pregnancy and sexually transmitted infections including HIV. To inform culturally-tailored dual protection interventions to prevent both unintended pregnancy and STIs/HIV, this study qualitatively examined girls\' sexual health intervention preferences. Participants were aged 14-17 years old and Sesotho-speaking (N = 25). To elucidate shared cultural beliefs, individual interviews examined participants\' perceptions about other adolescent girls\' pregnancy and STI/HIV prevention intervention preferences. Interviews were conducted in Sesotho and translated into English. Two independent coders identified key themes in the data using a conventional content analysis approach with discrepancies resolved by a third coder. Participants indicated that intervention content should include efficacious pregnancy and STI/HIV prevention methods and ways to navigate peer pressure. Interventions should be accessible, avoid criticism and provide high-quality information. Preferred intervention formats included online, SMS/text, or delivery by social workers or older, knowledgeable peers, with mixed acceptability for delivery by parents or same-age peers. Schools, youth centres and sexual health clinics were preferred intervention settings. Results highlight the importance of cultural context in tailoring dual protection interventions to address the reproductive health disparities among adolescent girls in South Africa.
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  • 文章类型: Journal Article
    长期以来,性别不平等一直被认为是影响撒哈拉以南非洲(SSA)艾滋病毒流行动态的最重要因素之一。然而,目前尚不清楚在艾滋病毒预防举措中如何讨论男性和女性,以及男性和女性的某些陈述是否会影响预防指导。这项研究旨在了解联合国艾滋病规划署为SSA地区制定的艾滋病毒预防指南中如何描述男女,以及这些如何影响针对女性和男性的不同类型的干预措施。研究中包括了34份艾滋病规划署预防文件。对政策文件进行了分析,以确定建议的不同干预措施的频率,他们针对男性和女性的程度,以及对男女代表方式的文本分析。由于缺乏关于其他性别认同的信息,这项研究只针对顺式男女。分析显示,大多数政策文件侧重于妇女,针对男性和女性的干预类型存在差异,很少有针对男性的社会干预,用来描述男人和女人的语言重复了传统的性别刻板印象,并巩固了简单化的二元论。缺乏针对男性的社会干预措施表明,在当前的预防举措中,男性的行为改变并未得到高度重视。相反,艾滋病规划署目前的政策侧重于妇女作为干预和赋权的关键场所。因此,UNAIDS应提供更多细节和例子,说明如何最好地让男子和男孩参与预防工作,以及在政策指导中纳入更细微的性别概念。
    Gender inequalities have long been recognised as one of the most significant factors influencing the dynamics of the HIV epidemic in sub-Saharan Africa (SSA). However, it remains unclear how men and women are discussed in HIV-prevention initiatives and if certain representations of men and women impact prevention guidance. This research aimed to understand how men and women are portrayed in HIV-prevention guidelines produced by UNAIDS for the SSA region, and how these influence the different types of interventions targeted at women and men. Thirty-four UNAIDS prevention documents were included in the study. The policy documents were analysed to ascertain the frequency of different interventions suggested, the extent to which they were targeted at men and women, and a textual analysis of the way that men and women were represented. Due to a lack of information regarding other gender identities, the research was aimed at cis-gender men and women only. The analysis revealed that most policy documents focused on women, that there were differences in the types of interventions targeted at men and women, with few social interventions targeted at men, and that the language used to describe men and women repeats traditional gender stereotypes and cements simplistic dualisms. The lack of social interventions targeted at men suggests that behaviour change among men is not highly prioritised in current prevention initiatives. Instead, current UNAIDS policy focuses on women as the key site for intervention and empowerment. UNAIDS should therefore provide more details and examples about how best to engage men and boys in prevention efforts, as well as to include more nuanced conceptions of gender in policy guidance.
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  • 文章类型: Journal Article
    背景:近年来,艾滋病毒检测频率增加,导致更多的人在血清转换期间被诊断为CD4计数暂时较低。使用当前HIV晚期呈递的共识定义(CD4计数<350细胞/μL或AIDS定义事件的护理呈递,无论CD4计数如何),这些个体都将被错误地分配为晚期诊断。
    方法:在2022年春季,一个欧洲专家组召开会议,以修改当前的晚期HIV公开共识定义。向指定的负责艾滋病毒监测的欧洲联络点(n=53)发送了关于应用该修订定义的数据可用性的调查。
    结果:专家们一致认为,更新的定义应该是指HIV晚期诊断而不是表现,并包括以下补充:有近期感染证据的人应该被重新分类为“非晚期”,最近感染的证据被认为是分层的。个体必须具有:(i)最近感染的实验室证据;(ii)诊断后12个月内的最后一次HIV检测阴性;或(iii)急性感染的临床证据。有证据表明以前在国外被诊断的人应该被排除在外。共有18个国家对调查做出了回应;83%的国家报告通过国家监测在诊断时捕获CD4计数和/或艾滋病,67%的人获得了最后一次阴性测试和/或先前的HIV诊断,61%在诊断时捕获血清转换疾病,28%捕获事件抗体结果。
    结论:关于晚期诊断的准确数据对于描述检测方案的效果很重要。对最近感染的个人进行重新分类将有助于更好地确定最有可能感染艾滋病毒的人群和干预领域。
    In recent years, HIV testing frequency has increased, resulting in more people being diagnosed during seroconversion with a temporarily low CD4 count. Using the current consensus definition of late HIV presentation (\'presenting for care with a CD4 count < 350 cells/μL or an AIDS-defining event, regardless of CD4 count\') these individuals would be incorrectly assigned as being diagnosed late.
    In spring 2022, a European expert group convened to revise the current late HIV presentation consensus definition. A survey on data availability to apply this revised definition was sent to nominated European focal points responsible for HIV surveillance (n = 53).
    Experts agreed that the updated definition should refer to late HIV diagnosis rather than presentation and include the following addition: People with evidence of recent infection should be reclassified as \'not late\', with evidence of recent infection considered hierarchically. The individual must have: (i) laboratory evidence of recent infection; (ii) a last negative HIV test within 12 months of diagnosis; or (iii) clinical evidence of acute infection. People with evidence of being previously diagnosed abroad should be excluded. A total of 18 countries responded to the survey; 83% reported capturing CD4 count and/or AIDS at diagnosis through national surveillance, 67% captured last negative test and/or previous HIV diagnosis, 61% captured seroconversion illness at diagnosis and 28% captured incident antibody results.
    Accurate data on late diagnosis are important to describe the effects of testing programmes. Reclassification of individuals with recent infection will help to better identify populations most at risk of poor HIV outcomes and areas for intervention.
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  • 文章类型: Journal Article
    欧洲艾滋病临床学会(EACS)指南在2021年进行了第17次修订,更新了艾滋病毒护理的各个方面。
    指南的11.0版推荐了抗逆转录病毒治疗(ART)初治成人的六种一线治疗选择:替诺福韦为主的骨架加未加强的整合酶抑制剂或加用多拉韦林;阿巴卡韦/拉米夫定加用杜鲁特韦;或拉米夫定或恩曲他滨加用杜鲁特韦双重治疗。关于从出生到青春期的首选和替代一线组合的建议包含在Penta的新儿科部分中。长效cabotegravir加利匹韦林被包括作为开关选项,和Fostemsavir一起,被添加到所有药物-药物相互作用(DDI)表中。四个新的抗结核药物DDI表,抗焦虑药,引入了激素替代疗法和COVID-19疗法,以及对焦虑症筛查和管理的指导,跨性别健康,女性的性健康和更年期。关于脆弱的部分,肥胖和癌症扩大了,对糖尿病和心血管疾病风险患者的管理建议进行了广泛修订.建议使用持续的危险行为治疗最近获得的丙型肝炎,以减少传播。丁维肽被包括作为丁型肝炎病毒的治疗选择。根据2020年世界卫生组织建议调整耐药结核病指南。最后,有关于COVID-19管理的新指南,重点是持续的艾滋病毒护理。2021年,《EACS指南》得到了广泛更新和扩展,包括了新的章节。这些建议可以作为一个免费的应用程序,在交互式网络格式和作为在线pdf。
    The European AIDS Clinical Society (EACS) Guidelines were revised in 2021 for the 17th time with updates on all aspects of HIV care.
    Version 11.0 of the Guidelines recommend six first-line treatment options for antiretroviral treatment (ART)-naïve adults: tenofovir-based backbone plus an unboosted integrase inhibitor or plus doravirine; abacavir/lamivudine plus dolutegravir; or dual therapy with lamivudine or emtricitabine plus dolutegravir. Recommendations on preferred and alternative first-line combinations from birth to adolescence were included in the new paediatric section made with Penta. Long-acting cabotegravir plus rilpivirine was included as a switch option and, along with fostemsavir, was added to all drug-drug interaction (DDI) tables. Four new DDI tables for anti-tuberculosis drugs, anxiolytics, hormone replacement therapy and COVID-19 therapies were introduced, as well as guidance on screening and management of anxiety disorders, transgender health, sexual health for women and menopause. The sections on frailty, obesity and cancer were expanded, and recommendations for the management of people with diabetes and cardiovascular disease risk were revised extensively. Treatment of recently acquired hepatitis C is recommended with ongoing risk behaviour to reduce transmission. Bulevirtide was included as a treatment option for the hepatitis Delta virus. Drug-resistant tuberculosis guidance was adjusted in accordance with the 2020 World Health Organization recommendations. Finally, there is new guidance on COVID-19 management with a focus on continuance of HIV care.
    In 2021, the EACS Guidelines were updated extensively and broadened to include new sections. The recommendations are available as a free app, in interactive web format and as an online pdf.
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  • 文章类型: Journal Article
    通过制定基于共识的最佳实践指南来优化与“高风险”脊柱畸形手术相关的术中神经监测(IONM)事件的方法,从而扩展先前描述的术中辅助手段。
    通过德尔菲法,在一组经验丰富的脊柱畸形外科医生中达成共识。通过一系列的迭代调查和最后的虚拟共识会议,与会者表示同意(强烈同意,同意,不同意,并且强烈不同意)各种项目。共识被定义为≥80%的协议(“强烈同意”或“同意”)。接近共识定义为≥60%但<80%。平衡≥20%但<60%,排除的共识是<20%。
    15位(100%)受邀外科医生中的15位同意参加。最终共识支持包含105个项目(53个在响应算法中,13在持续考虑病因学,31在实时数据场景中,IONM损失模式中的8个),它们被组织成一套最终的最佳实践指南。
    成功创建了详细的基于共识的最佳实践指南和辅助工具,旨在帮助组织和指导手术团队探索和应对高风险脊柱畸形手术期间的神经系统并发症。
    V级
    To expand on previously described intraoperative aids by developing consensus-based best practice guidelines to optimize the approach to intraoperative neuromonitoring (IONM) events associated with \"high-risk\" spinal deformity surgery.
    Consensus was established among a group of experienced spinal deformity surgeons by way of the Delphi method. Through a series of iterative surveys and a final virtual consensus meeting, participants expressed their agreement (strongly agree, agree, disagree, and strongly disagree) with various items. Consensus was defined as ≥ 80% agreement (\"strongly agree\" or \"agree\"). Near-consensus was defined as ≥ 60% but < 80%. Equipoise was ≥ 20% but < 60%, and consensus to exclude was < 20%.
    15 out of 15 (100%) invited surgeons agreed to participate. Final consensus supported inclusion of 105 items (53 in Response Algorithm, 13 in Ongoing Consideration of Etiology, 31 in Real-Time Data Scenarios, 8 in Patterns of IONM Loss), which were organized into a final set of best practice guidelines.
    Detailed consensus-based best practice guidelines and aids were successfully created with the intention to help organize and direct the surgical team in exploring and responding to neurological complications during high-risk spinal deformity surgery.
    Level V.
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  • 文章类型: Journal Article
    回顾和总结公共卫生服务(PHS)指南和器官采购和移植网络(OPTN)法规的演变,以通过流行文化的镜头预防实体器官移植中血液传播的病毒传播,科学进化,患者和从业者偏见和结果研究。
    最新的一套指南和法规于2020年发布,代表了数十年来的观点的高潮。在科学界和外行社区内进行研究和辩论。
    这些准则是为了解决公众的关注,以及在新的艾滋病公共卫生危机的背景下,未确诊疾病传播的风险。我们回顾了从1981年第一次描述艾滋病到现在的科学和非专业媒体的里程碑出版物,以帮助说明指南制定的背景,他们在后续版本中改变的方式,并通过当前的一套指导方针和潜在的前进方向对问题进行批判性考虑。应进一步考虑当前准则确定具有传染病传播风险标准的捐助者的方式,并授权向潜在接受者解释特定于捐助者的风险因素,在我们普遍的捐赠者筛查和接受者监测时代。
    To review and summarize the evolution of the Public Health Service (PHS) guidelines and Organ Procurement and Transplantation Network (OPTN) regulations for the prevention of blood borne virus transmission in solid organ transplant through the lens of popular culture, scientific evolution, patient and practitioner bias and outcomes research.
    The most recent set of guidelines and regulations were released in 2020 and represent a culmination of decades of opinion, research and debate within the scientific and lay communities.
    The guidelines were created to address public concern, and the risk of undiagnosed disease transmission in the context of the novel public health crisis of AIDS. We reviewed milestone publications from the scientific and lay press from the first description of AIDS in 1981 to the present to help illustrate the context in which the guidelines were created, the way they changed with subsequent editions, and offer critical consideration of issues with the current set of guidelines and a potential way forward. Further consideration should be given to the way in which the current guidelines identify donors with risk criteria for infectious disease transmission and mandate explanation of donor-specific risk factors to potential recipients, in our era of universal donor screening and recipient surveillance.
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  • 文章类型: Journal Article
    我们提出了更新的英国性健康与HIV协会(BASHH)性暴露后HIV暴露后预防(PEP)指南,社区中的职业暴露和其他非职业暴露。这是对2015年BASHH性暴露后PEP指南和2008年艾滋病专家咨询小组HIVPEP指南的更新。我们的目标是在条款中提供最佳临床实践的循证指导,监测和支持PEP预防性行为后感染艾滋病毒,社区中的职业和其他非职业暴露。该指南涵盖了何时开PEP,使用什么抗逆转录病毒药物以及如何管理PEP。这包括(i)PEP功效的证据;(ii)与抗逆转录病毒疗法预防艾滋病毒性传播的个人水平功效有关的证据;(iii)有关特定人群中可检测(可传播)艾滋病毒流行率的数据;(iv)不同类型的性和职业接触后的艾滋病毒传播风险;(v)基线风险评估;(vi)药物方案和给药时间表;(vii)监测PEP;(viii)在更广泛的血液中例如,HIV暴露前预防(PrEP)。该指南还涵盖了特殊情况,如怀孕期间的PEP,母乳喂养和慢性乙型肝炎病毒感染,当使用HIVPrEP的人应该考虑PEP时。该指南针对直接参与PEP提供的临床专业人员和该领域的其他利益相关者。包括协助PEP咨询的形式。在最后确定建议之前,进行了公众协商。
    We present the updated British Association for Sexual Health and HIV (BASHH) guidelines for post-exposure prophylaxis (PEP) to HIV following sexual exposures, occupational exposures and other nonoccupational exposures in the community. This serves as an update to the 2015 BASHH guideline on PEP following sexual exposures and the 2008 Expert Advisory Group on AIDS guidelines on HIV PEP. We aim to provide evidence-based guidance on best clinical practice in the provision, monitoring and support of PEP for the prevention of HIV acquisition following sexual, occupational and other nonoccupational exposures in the community. The guideline covers when to prescribe PEP, what antiretroviral agents to use and how to manage PEP. This includes (i) evidence of PEP efficacy; (ii) evidence relating to individual-level efficacy of antiretroviral therapy to prevent the sexual transmission of HIV; (iii) data on the detectable (transmissible) prevalence of HIV in specific populations; (iv) risk of HIV transmission following different types of sexual and occupational exposure; (v) baseline risk assessment; (vi) drug regimens and dosing schedules; (vii) monitoring PEP; (viii) baseline and follow-up blood-borne virus testing; (ix) the role of PEP within broader HIV prevention strategies, for example, HIV pre-exposure prophylaxis (PrEP). The guideline also covers special scenarios such as PEP in pregnancy, breastfeeding and chronic hepatitis B virus infection, and when PEP should be considered in people using HIV PrEP. The guidelines are aimed at clinical professionals directly involved in PEP provision and other stakeholders in the field. A proforma to assist PEP consultations is included. A public consultation process was undertaken prior to finalizing the recommendations.
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