HIV非职业暴露后的预防现状

Actuality of nonoccupational postexposure prophylaxis against HIV shanghai public health centre

非职业暴露后预防(nPEP)是指包括对性暴露后与静脉药物注射暴露后的预防H IV感染的措施.应该尽可能早的开始(暴露后72 h内),用多种药物联合治疗连续28 d.nPEP中心理咨询也是重要的组成部分.抗逆转录病毒治疗首选2个核苷类逆转录酶抑制剂.相对于职业暴露来说nPEP在预防H IV感染方面没有很好的效果.容易失败的原因主要有:①延时治疗;②非职业暴露者对PEP治疗依从性差;③反复多次发生暴露;④进行肛交是预防H IV感染所面临的一个严峻的问题;⑤不合理的药物组合.

The term nPEP refres to the management of persons who have nonoccupational exposure （ include sexual and injection drug use exposure） to prevent acquired HIV infection, nPEP should be initiated as soon as possible （within 72 hours postexposure） and continued for 28 days with multiple drugs. The important part of nPEP is risk-reduction counseling. 2 nucleoside reversetranscriptase inhibitors will be warranted to the majority of exposures. As for occupational exposure, PEP is not completely effective in preventing HIV infection following nonoccupational exposure. There are a number of reasons why nPEP might have failed including： ①delayed therapy; ②a lack of adherence to the PEP regimen;③repeated exposures;④receptive anal intercourse is a severe test for prevention of HIV infection ;⑤a suboptimal drug regimen.