HIV感染的窗口期与暴露后检测策略

Window period of HIV infection and testing algorithm after exposure

HIV感染的窗口期是从HIV暴露到可持续量化检出病毒标志物的时期,抗体阳转的窗口期是从HIV暴露到稳定检出HIV抗体的时期。隐匿期(eclipse period)是从HIV暴露到血液中稳定检出病毒核酸的时期。理解窗口期是HIV检测咨询的基础,可以回答暴露后多长时间检测及重复检测、多长时间后检测的阴性结果可以排除HIV感染等关键问题,对于制定暴露后检测策略、选择检测方法和解释检测结果具有直接指导意义。本文介绍了窗口期的定义,强调了准确理解窗口期的要点,分析了影响窗口期的因素,特别是抗病毒药物对病毒标志物应答及检测的影响,提出了依据窗口期长短进行暴露后检测随访的方法和策略,以期为正确应用窗口期的概念指导暴露后检测暨急性期诊断提供参考。

The window period of HIV infection refers to the time between HIV exposure and quantified and consistent detection of viral markers.The seroconversion window period is the interval between HIV infection and the first detection of antibodies.The eclipse period is the initial phase from HIV infection to reliable detection of HIV RNA.Understanding the window period is the basis for HIV test counseling,helping to provide key information about how soon after HIV exposure the tests and repeat tests should be offered and when the HIV infection can be excluded after negative test results are obtained.It has guiding significance for formulating post-exposure testing algorithm,selecting tests and interpreting test results.This paper introduced the definition of window period,emphasized the main points for accurately understanding the concept,analyzed the factors affecting the window period,especially the impact of antiretroviral drugs on viral marker response and detection,and proposed the follow-up method and post-exposure test strategy based on the length of window period,aiming to provide reference for the diagnosis of acute HIV infection.