一起狂犬病病毒和HIV双暴露事件临床处置分析

Analysis of clinical treatment of dual exposure to rabies virus and HIV in an incident with multivictims bitten by a dog

目的分析北京市一起一犬伤多人（暴露者中有I例为HIV阳性者）事件处置情况，探讨狂犬病和HIV双暴露处置路径及预后。方法采用描述性流行病学调查方法对一起一犬伤多人事件的暴露者情况、狂犬病和HIV暴露后预防处置（post-exposure prophylaxis，PEP）措施和随访转归进行分析。结果9例暴露者经规范的狂犬病PPE，随访6个月未发生狂犬病病例。6例HIV阴性暴露正常人经HIV暴露后预防，随访12周未发生HIV阳转。结论一犬伤多人事件中，除狂犬病暴露外，更要警惕顺序咬伤人群中可能存在HIV、HBV、HCV感染状态造成潜在的其他血源性传染病传播的风险，尽早进行规范的PEP至关重要。

Objective To analyze the clinical response in cases of multi-victims bitten by a dog in Beijing （ one of whom was HIV positive） , and to explore the route and prognosis of dual exposure to rabies virus and HIV. Methods Descriptive epidemiologieal methods were used to analyze the exposed cases, the post-exposure prophylaxis（PEP） of rabies and HIV and the follow-up outcomes. Results After six monthsfollow up, there was no rabies case was found among those nine victims bitten by the suspected dog. In addition, six HIV-negative victims who had been exposed to HIV via dog saliva were consistently tested to be HIV negative in the follow up period. Conclusions In cases with multi-victims bitten by one dog, except exposure to rabies virus, it is necessary to be alert to the presence of HIV, HBV or HCV infection in sequential victims. Therefore, the risk of the potential spreading of other blood-borne infectious pathogens should be assessed. It is important to initiate PEP as early as possible.