炬绘┾浜锛╁浠ラ绘HIV锛

涓ゅぉ锛涓炬绘╃寰涓缁甯灏辫涓轰癸30涓跺灏辫寰浜杩9涓杞杩″井涓杩颁涓ㄨ澶у浠骞村ㄦ嘲介╁锛瀹涓HIV哄甫锛杩峰ジ锛琛╅绘杩绋

锛寰炬绘╃撅

褰澶╂涓锛涓惧版舵炬姣浼ゅ娴姹浼濯瀛㈢风锛ㄧ扳炬绘╃寰涔璁茶堪浜繁琚镜瀹冲ㄩ绘缁锛杩″井涔峰璧峰箍娉虫敞锛甯21灏跺浆4涓

锛寰ヨ繁哄甫HIV锛杩浠浜哄淇ゆц涓衡撅

瑙锛绀句澶т瀵光炬剁稿崇ヨ甯稿虫敞ｄ锛炬绘┾板浜

浠涔炬绘┾锛

璋炬绘┾锛绯诲姣╋跺瀵硅炬姣ㄤ汉浣澶剁涓楠よ琛骞叉帮浣垮杩ヤ汉浣炬姣涓芥甯稿娈涔灏辨锛绘╁跺骞朵芥姝昏炬姣韩锛芥や汉浣锛垮褰㈡姣

涓哄苟涓炬姣杩ヤ汉浣锛浜灏辨娉藉浜锛瑕缁姣杩ヤ汉浣渚垫浜轰澧娈╂ｄ镜村缁褰㈡杩绋锛琚炬姣渚靛ョ浜烘浼绘╁氨ㄥ藉浜炬姣杩ヤ跺烘锛灏姣诲块跺ㄢ澧娈╂ｄ镜村缁杩涓姝ヤ锛浣夸汉涓浼

炬姣瀛浜虹被己风姣锛HIV锛锛瀹芥浜轰郴缁缁锛浼ゅ跺姐HIV灏瀵艰村介娓琛伴锛虹己封涓弗己风稿崇琚О涓衡轰ф锛涓鸿浜ㄥ郴缁戒舵藉虹

炬瀛寰у己风患寰锛AIDS锛锛HIV舵HIV濡虹20浣绉轰ф涓浠讳涓绉锛涓HIV稿崇浠讳涓绉跨わ灏辨崇涓衡炬ｈ

HIV灞浜杞姣锛浠杩榛浼ゅ绛澶杩ヤ汉浣琛娑测锛扳褰㈡HIV锛瑕缁浠ヤ涓楠わ

1缁CD4+T缁琛ㄩ㈢浣锛骞惰ョ锛

2ㄩ杞朵ㄤ锛寮濮杞锛RNADNA锛

3DNA村板涓荤哄缁涓锛

4RNA朵ㄤ锛杞扮mRNA锛

5缈昏mRNA扮姣斤

6扮姣藉扮RNA缁瑁褰㈡扮姣棰绮锛

7炬扮姣棰绮锛缁х画渚垫村CD4+T缁

瑕涓浠ヤ7涓楠や腑涓姝ワ灏辫藉HIV锛叉褰㈡HIV锛杩灏辨HIV绘╃绘

HIV绘╂浠涔娉ㄦ椤癸

1灏藉揩

浜虹被杩娌¤界跺虹存娓ょ涓HIV╋HIV绘锛朵㈣浜姝ラ涓涓姝ワ浠HIV垫ㄦ渚垫ｅ板涓锛垮姣╂ｏ杩蜂ワ绛ｅ涓渚垫缁姝绘浠ュHIV灏辫惰跺伴娑浜

杩灏卞ソ．涓捣浜褰浠娉北讹杩浠ユ茬锛灏跺ㄤ瀹村锛叉胯寤跺板朵哄锛绛惰村灞辨琚у敖锛灞辩氨浼杩峰氨垮浜村ぇ澶便

HIV绘╀凤瑕灏芥╂灏辫藉姣瀹ㄤ寮濮缁锛娉╂ｃ姝わHIV绘椤诲敖蹇濡瓒杩72灏讹姣宸茬ㄤ澶跺鸿澶伴灏卞惧婚浠垮ご浜

HIV撮叉楂辫涓哄瑕澶缃纭舵绘杩100%

HIV撮插姝ｇ‘澶规涓猴

绗姝ワㄧ娑层娴ㄦ姘存姘寸叉涓锛辫蹇绔杩蹇绔交ゅ浼ゅ锛灏藉芥ゅ烘薄琛锛叉75%涔锛わ0.5%缁撮锛榛锛瀵逛激灞ㄦ姣锛

绗姝ワ绔冲寰褰扮炬涓锛HIV绘╋搴灏藉藉2灏朵ㄩ绘╋甯稿72灏朵ㄩ绘╋借捣伴绘╋绘瓒濂斤

绗姝ワㄦ撮插绗堕淬绗4ㄣ绗8ㄣ绗12ㄥ绗24ㄥ琛HIV浣妫娴锛骞舵蹇骞查ㄨ

楂辫涓哄澶缃规锛涓杩扮浜姝ャ绗姝ョ稿

2澶绉

HIV绘涓哄ぇ绫伙涓轰淇╄捣瑙锛甯搁瑕浣跨ㄨ冲涓绉绘锛杩涓绉冲瑕灞浜ぇ绫讳腑涓ょ被荤浼规╂垫ヨ琛╋纭╁敖芥兜村箍娉淬濡浣瑕绘涓濡ㄦ稿涓涓繁╂灞浜冲涓や釜涓绫诲

ぇ绫HIV绘

跺锛Fusion Inhibitors锛锛瀵规楠1锛璁HIV涓戒琛ㄩ㈢浣缁锛渚濡╁かEnfuvirtide锛

杩ユ跺锛Entry Inhibitors锛锛瀵规楠1锛璁HIV涓借ョ锛渚濡惧嘲Albuvirtide锛

歌风被杞舵跺锛NNRTIs,non-nucleosidereverse-transcriptase inhibitors锛锛瀵规楠2锛璁╄HIVヤ镜缁娉DNA锛渚濡胯绂TDF渚鸡EFV濂骞NVP渚查ETV绛锛

歌风被浼肩╅杞舵跺锛NRTIs,non-nucleosidereverse-transcriptase inhibitor锛锛瀵规楠2锛璁╄HIVヤ镜缁娉DNA锛渚濡榻澶澶AZT/ZDV缇ddI垮反￠ABC绛锛

村堕捐浆绉绘跺锛INSTIs,integrase strand transfer inhibitors锛锛瀵规楠3锛浣垮缁琚HIVDNA娉村扮哄缁涓锛渚濡挎RAL锛

借川跺锛PIs,protenase inhibitors锛锛瀵规楠5锛浣垮缁娉HIV搴缂借川锛渚濡娲归ｉLPV澶ｉFPV挎ｉATV绛

3璋ㄩ靛诲

变HIV绘╀腑寰澶芥瀵逛汉浣涓惰捣锛瀹璐ㄤ涓锛锯般绫讳技浜瀛杩浜锛涓轰涓璁╅瀛╃ㄦ璧婧ュ．澶у骞茶涓瀛т姝ｅ涓哄姝わ杩浜HIV绘╃ㄥ寰涔浼寰澶э涓繁浣涓诲ㄧ蹇瑕ㄦ舵涓瑕瑰匡棰茶炬蹇究ㄣ

涓缁缁ㄣ浣跨ㄦ杞姣娌荤棰茶炬姣缁煎涓轰HIV娌荤绘腑甯歌涓浜╃姣у遍╁绱锛

瀵逛姝ｉ瑕杩琛炬撮插棰诧PrEP锛浜虹兢锛渚濡风锋ф瑙浜藉板虹у伐浣绛锛变茬ㄨ绘骞朵瀹ㄧ稿锛璀涓缁缁寮虹寤鸿浠浠渚瀵椹告胯绂TDF锛锛杩璇ュㄥ荤瀵间杩琛棰层

4惧蹇

濡寤惰撮绘け璐ワHIV撮插挎堕存锛涔涓蹇瑙涓烘ユヤ复

惧淇ゆц涓虹浜恒缁父瑕杈娉ㄨ娑插跺ｈ杈娉ㄨHIV妫娴琛娑茬ｈ浠瑙娑茬瑰琛涓浠绛蹇ц繁琚浜猴浠ラ杩琛娓瀛娴ョ‘瀹HIV

濡绗娆℃ョ涓洪存э杩涓妫ヤ朵负存э纭骞舵HIV濡妫ョ涓洪虫э杩惰澶浜╂锛瑕跺氨璇靛诲辨不淇ソ娲讳蹇蹇瑕舵绉棰插朵剧ㄨラ垮轰ф锛瀹ㄥ浠ユ寰澶ф瀹缁剁瀛锛涓娲昏川棰瀵垮戒骞朵浼捐浣

1涓缁缁跨绠ャ撮插棰诧PrEP锛锛涓缁╁ぇ浜炬撮插棰诧PrEP锛寤鸿淬2015骞11

2涓缁缁浣跨ㄦ杞姣娌荤棰茶炬姣缁煎锛瀵瑰卞界寤鸿2013骞6

3Lunding S, et al. The Danish PEP Registry: Experience with the use of post-exposure prophylaxis following blood exposure to HIV from 1999-2012. Infect Dis (Lond).2016;48(3):195-200. doi: 10.3109/23744235.2015.1103896. Epub 2015 Nov 3.

4Aminde LN, et al. Occupational post-exposure prophylaxis (PEP) against human immunodeficiency virus (HIV) infection in a health district in Cameroon: assessment of the knowledge and practices of nurses. PLoS One.2015 Apr 16;10(4):e0124416. doi: 10.1371/journal.pone.0124416. eCollection 2015.