晚发现艾滋病病毒感染临床管理专家共识

Expert consensus on the clinical management of HIV late presentation

随着联合抗反转录病毒治疗(combination antiretroviral therapy,cART)的进步,全球艾滋病病毒(HIV)新发感染及相关死亡人数已显著下降,但“晚发现”(late presentation,即就诊时伴低CD4细胞计数或艾滋病定义性事件)HIV感染者比例高仍是艾滋病防治的重要挑战之一。晚发现HIV感染者临床风险高、管理复杂,且具有较高的传播风险,对达成“三个95%”及终结艾滋病流行目标造成较大挑战。然而,目前国内外均缺乏专门针对这一人群的临床管理规范。因此,中国人体健康科技促进会免疫缺陷监测与转化专业委员会组织领域内专家,根据近年来国内外最新研究证据和临床实践经验,探讨晚发现HIV感染者的定义、临床特征和风险,以及抗病毒治疗策略等临床管理问题,并制定具体推荐意见,旨在为临床工作者提供参考。

With the advancement of combination antiretroviral therapy(cART),the global number of new HIV infections and HIV-related mortality has significantly declined.However,the high proportion of"late presentation"(defined as presenting to care with a low CD4 cell count or AIDS-defining events)among HIV-infected individuals remains a significant challenge in HIV prevention and treatment.HIV late presentation is associated with increased clinical risk,complex management,and higher risk of transmission,and represents a significant barrier to achieving the"95-95-95"targets and ending the HIV epidemic.Currently,both nationally and internationally,there is a lack of specific clinical guidelines for this population.Therefore,the China Association for Promotion of Health Science and Technology convened experts in the field to discuss the definition,clinical characteristics,risks,and cART of late presenters based on the latest research evidence and clinical practices both domestically and internationally.Specific recommendations were formulated to guide healthcare professionals in their clinical practice.