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prophylaxis\uff0cPrEP\uff09\u548c\u66b4\u9732\u540e\u9884\u9632\uff08Post-exposure prophylaxis\uff0cPEP\uff09\u3002<\/p>\n<p>2 \u75c5\u539f\u5b66\u7279\u5f81<\/p>\n<p>HIV\u5728\u75c5\u6bd2\u5206\u7c7b\u5b66\u4e0a\u5c5e\u4e8e\u53cd\u8f6c\u5f55\u75c5\u6bd2\u79d1\u6162\u75c5\u6bd2\u5c5e\u4e2d\u7684\u4eba\u7c7b\u6162\u75c5\u6bd2\u7ec4\uff0c\u4e3a\u76f4\u5f84100~120 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\u2103\u5904\u740630 min\u53ef\u4f7fHIV\u5728\u4f53\u5916\u5bf9\u4eba\u7684T\u6dcb\u5df4\u7ec6\u80de\u5931\u53bb\u611f\u67d3\u6027\uff0c\u4f46\u4e0d\u80fd\u5b8c\u5168\u706d\u6d3b\u8840\u6e05\u4e2d\u7684HIV\uff1b100 \u2103\u5904\u740620 min\u53ef\u5c06HIV\u5b8c\u5168\u706d\u6d3b\u3002<\/p>\n<p>3 \u5b9e\u9a8c\u5ba4\u68c0\u67e5<\/p>\n<p>HIV\/AIDS\u60a3\u8005\u7684\u5b9e\u9a8c\u5ba4\u68c0\u6d4b\u4e3b\u8981\u5305\u62ecHIV\u6297\u4f53\u68c0\u6d4b\u3001HIV\u6838\u9178\u5b9a\u6027\u548c\u5b9a\u91cf\u68c0\u6d4b\u3001CD4+ 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T\u6dcb\u5df4\u7ec6\u80de\u6cbb\u7597\u7684\u60a3\u8005\u6309\u7167\u4e34\u5e8a\u60c5\u51b5\u5b9a\u671f\u68c0\u6d4b\u3002<\/p>\n<p>CD4+\/CD8+T\u6dcb\u5df4\u7ec6\u80de\u6bd4\u503c\u5012\u7f6e\u53ef\u5728\u957f\u671fART\u540e\u51fa\u73b0\u4e0d\u540c\u7a0b\u5ea6\u7684\u6539\u5584\uff0c\u4e0e\u60a3\u8005\u8d77\u59cb\u6cbb\u7597\u7684\u65f6\u673a\u548c\u57fa\u7840CD4+T\u6dcb\u5df4\u7ec6\u80de\u8ba1\u6570\u5bc6\u5207\u76f8\u5173\uff0c\u5176\u53d8\u5316\u63d0\u793a\u60a3\u8005\u7684\u6cbb\u7597\u6548\u679c\u548c\u514d\u75ab\u708e\u75c7\u72b6\u6001\uff3b8\uff3d\u3002<\/p>\n<p>3.3\u3000HIV\u6838\u9178\u68c0\u6d4b\u3000\u611f\u67d3HIV\u4ee5\u540e\uff0c\u75c5\u6bd2\u5728\u4f53\u5185\u5feb\u901f\u590d\u5236\uff0c\u8840\u6d46\u4e2d\u53ef\u5b9a\u91cf\u68c0\u6d4b\u51fa\u75c5\u6bd2RNA\u7684\u91cf\uff08\u75c5\u6bd2\u8f7d\u91cf\uff09\uff0c\u4e00\u822c\u7528\u6bcf\u6beb\u5347\u8840\u6d46\u4e2dHIV RNA\u7684\u62f7\u8d1d\u6570\uff08\u62f7\u8d1d\/mL\uff09\u6216\u56fd\u9645\u5355\u4f4d\uff08IU\/mL\uff09\u6765\u8868\u793a\u3002\u75c5\u6bd2\u8f7d\u91cf\u68c0\u6d4b\u7ed3\u679c\u4f4e\u4e8e\u68c0\u6d4b\u4e0b\u9650\uff0c\u8868\u793a\u672c\u6b21\u8bd5\u9a8c\u6ca1\u6709\u68c0\u6d4b\u51fa\u75c5\u6bd2\u8f7d\u91cf\uff0c\u89c1\u4e8e\u672a\u611f\u67d3HIV\u7684\u4e2a\u4f53\u3001ART\u6210\u529f\u7684\u60a3\u8005\u6216\u81ea\u8eab\u53ef\u6709\u6548\u6291\u5236\u75c5\u6bd2\u590d\u5236\u7684\u90e8\u5206HIV\u611f\u67d3\u8005\u3002\u75c5\u6bd2\u8f7d\u91cf\u68c0\u6d4b\u7ed3\u679c\u9ad8\u4e8e\u68c0\u6d4b\u4e0b\u9650\uff0c\u8868\u793a\u672c\u6b21\u8bd5\u9a8c\u68c0\u6d4b\u51fa\u75c5\u6bd2\u8f7d\u91cf\uff0c\u53ef\u7ed3\u5408\u6d41\u884c\u75c5\u5b66\u53f2\u3001\u4e34\u5e8a\u75c7\u72b6\u53caHIV\u6297\u4f53\u521d\u7b5b\u7ed3\u679c\u505a\u51fa\u5224\u65ad\u3002<\/p>\n<p>\u68c0\u6d4b\u75c5\u6bd2\u8f7d\u91cf\u7684\u5e38\u7528\u65b9\u6cd5\u6709\u53cd\u8f6c\u5f55PCR\uff08RT-PCR\uff09\u3001\u6838\u9178\u5e8f\u5217\u4f9d\u8d56\u6027\u6269\u589e\uff08NASBA\uff09\u6280\u672f\u548c\u5b9e\u65f6\u8367\u5149\u5b9a\u91cfPCR\u6269\u589e\u6280\u672f\uff08Real-time PCR\uff09\u3002\u75c5\u6bd2\u8f7d\u91cf\u6d4b\u5b9a\u7684\u4e34\u5e8a\u610f\u4e49\uff1a\u9884\u6d4b\u75be\u75c5\u8fdb\u7a0b\u3001\u8bc4\u4f30ART\u7597\u6548\u3001\u6307\u5bfcART\u65b9\u6848\u8c03\u6574\uff1b\u4e5f\u53ef\u4f5c\u4e3aHIV\u611f\u67d3\u8bca\u65ad\u7684\u8865\u5145\u8bd5\u9a8c\uff0c\u7528\u4e8e\u6025\u6027\u671f\/\u7a97\u53e3\u671f\u4ee5\u53ca\u665a\u671f\u60a3\u8005\u7684\u8bca\u65ad\u3001HIV\u611f\u67d3\u8005\u7684\u8bca\u65ad\u548c\u5c0f\u4e8e18\u6708\u9f84\u5a74\u5e7c\u513fHIV\u611f\u67d3\u7684\u8bca\u65ad\u3002<\/p>\n<p>\u6838\u9178\u68c0\u6d4b\u65b9\u6cd5\uff08\u5b9a\u6027\u548c\u5b9a\u91cf\uff09\uff1a\u5c5e\u4e8eHIV\u68c0\u6d4b\u4e2d\u7684\u6838\u9178\u8865\u5145\u5b9e\u9a8c\uff0c\u6838\u9178\u5b9a\u6027\u68c0\u6d4b\u7ed3\u679c\u9633\u6027\u62a5\u544aHIV-1\u6838\u9178\u9633\u6027\uff0c\u7ed3\u679c\u9634\u6027\u62a5\u544aHIV-1\u6838\u9178\u9634\u6027\u3002RNA\u8f7d\u91cf\u68c0\u6d4b\u7ed3\u679c\u4f4e\u4e8e\u68c0\u6d4b\u4e0b\u9650\uff0c\u62a5\u544a\u4f4e\u4e8e\u68c0\u6d4b\u4e0b\u9650\uff1b&gt;5 000\u62f7\u8d1d\/mL\u62a5\u544a\u68c0\u6d4b\u503c\uff1b\u68c0\u6d4b\u9650\u4ee5\u4e0a\u4f46\u22645 000\u62f7\u8d1d\/mL\u5efa\u8bae\u91cd\u65b0\u91c7\u6837\u68c0\u6d4b\uff0c\u4e34\u5e8a\u533b\u751f\u53ef\u7ed3\u5408\u6d41\u884c\u75c5\u5b66\u53f2\u3001\u4e34\u5e8a\u8868\u73b0\u3001CD4+\u4e0eCD8+T\u6dcb\u5df4\u7ec6\u80de\u8ba1\u6570\u6216HIV\u6297\u4f53\u968f\u8bbf\u68c0\u6d4b\u7ed3\u679c\u7b49\u6765\u786e\u8bca\u6216\u6392\u9664\u8bca\u65ad\u3002DNA\u8f7d\u91cf\u68c0\u6d4b\u7ed3\u679c\u7684\u5224\u5b9a\u53c2\u7167\u8bd5\u5242\u76d2\u8bf4\u660e\u4e66\u3002<\/p>\n<p>\u75c5\u6bd2\u8f7d\u91cf\u68c0\u6d4b\u9891\u7387\uff1a\u5728ART\u524d\u5e94\u8fdb\u884c\u4e00\u6b21\u68c0\u6d4b\uff0c\u5982\u679c\u672a\u542f\u52a8ART\uff0c\u5efa\u8bae\u5b9a\u671f\u68c0\u6d4b\u3002\u521d\u59cb\u6cbb\u7597\u540e\uff0c\u5efa\u8bae\u7b2c1\u6b21\u68c0\u6d4b\u5e94\u5728\u6cbb\u7597\u540e4\u5468\u5de6\u53f3\uff0c\u7136\u540e\u6bcf3\u4e2a\u6708\u68c0\u6d4b\u4e00\u6b21\u76f4\u5230\u75c5\u6bd2\u8f7d\u91cf\u5b8c\u5168\u88ab\u6291\u5236\u3002\u6cbb\u7597\u540e\u4e24\u5e74\u4ee5\u5185\uff0c\u5efa\u8bae\u6bcf3~4\u4e2a\u6708\u68c0\u6d4b\u4e00\u6b21\u3002\u6cbb\u7597\u4e24\u5e74\u4ee5\u540e\uff0c\u5982\u679c\u75c5\u6bd2\u8f7d\u91cf\u88ab\u7a33\u5b9a\u6291\u5236\uff0c\u5219\u6bcf6\u4e2a\u6708\u68c0\u6d4b\u4e00\u6b21\u3002\u5982\u56e0ART\u5931\u8d25\u8c03\u6574\u6cbb\u7597\u65b9\u6848\uff0c\u5efa\u8bae\u7b2c1\u6b21\u68c0\u6d4b\u5e94\u5728\u8c03\u6574\u65b9\u6848\u540e\u76844\u5468\u8fdb\u884c\uff0c\u7136\u540e\u6bcf3\u4e2a\u6708\u68c0\u6d4b\u4e00\u6b21\u76f4\u5230\u75c5\u6bd2\u8f7d\u91cf\u5f97\u5230\u6291\u5236\u3002\u5982\u56e0\u4e3a\u836f\u7269\u6bd2\u6027\u6216\u7b80\u5316\u836f\u7269\u65b9\u6848\u5bf9\u75c5\u6bd2\u6291\u5236\u7684\u60a3\u8005\u66f4\u6362ART\u65b9\u6848\uff0c\u5e94\u5728\u8c03\u6574\u65b9\u6848\u540e4\u5468\u8fdb\u884c\u68c0\u6d4b\u786e\u8ba4\u75c5\u6bd2\u8f7d\u91cf\u5f97\u5230\u6291\u5236\u3002\u5982\u679c\u6cbb\u7597\u8fc7\u7a0b\u4e2d\u75c5\u6bd2\u8f7d\u91cf&gt;200\u62f7\u8d1d\/mL\uff0c\u5efa\u8bae\u6bcf3\u4e2a\u6708\u68c0\u6d4b\u3002\u5bf9\u4e8e\u65b0\u51fa\u73b0\u827e\u6ecb\u75c5\u76f8\u5173\u4e34\u5e8a\u75c7\u72b6\u6216\u4f7f\u7528\u7cd6\u76ae\u8d28\u6fc0\u7d20\u6216\u6297\u80bf\u7624\u5316\u7597\u836f\u7269\u7684\u60a3\u8005\uff0c\u9700\u6bcf3\u4e2a\u6708\u8fdb\u884c\u4e00\u6b21\u6838\u9178\u68c0\u6d4b\u3002<\/p>\n<p>3.4\u3000HIV\u57fa\u56e0\u578b\u8010\u836f\u68c0\u6d4b\u3000HIV\u8010\u836f\u68c0\u6d4b\u7ed3\u679c\u53ef\u4e3aART\u65b9\u6848\u7684\u5236\u8ba2\u548c\u8c03\u6574\u63d0\u4f9b\u53c2\u8003\u3002<\/p>\n<p>\u51fa\u73b0HIV\u8010\u836f\uff0c\u8868\u793a\u8be5\u611f\u67d3\u8005\u4f53\u5185\u75c5\u6bd2\u53ef\u80fd\u8010\u836f\uff0c\u540c\u65f6\u9700\u8981\u5bc6\u5207\u7ed3\u5408\u4e34\u5e8a\u60c5\u51b5\uff0c\u5145\u5206\u8003\u8651\u60a3\u8005\u7684\u4f9d\u4ece\u6027\uff0c\u5bf9\u836f\u7269\u7684\u8010\u53d7\u6027\u53ca\u836f\u7269\u7684\u4ee3\u8c22\u5438\u6536\u7b49\u56e0\u7d20\u8fdb\u884c\u7efc\u5408\u8bc4\u5224\u3002\u6539\u53d8ART\u65b9\u6848\u9700\u8981\u5728\u6709\u7ecf\u9a8c\u7684\u533b\u5e08\u6307\u5bfc\u4e0b\u8fdb\u884c\u3002HIV\u8010\u836f\u68c0\u6d4b\u7ed3\u679c\u5448\u9634\u6027\uff0c\u8868\u793a\u8be5\u4efd\u6837\u54c1\u672a\u68c0\u51fa\u8010\u836f\u6027\uff0c\u4f46\u4e0d\u80fd\u786e\u5b9a\u8be5\u611f\u67d3\u8005\u4f53\u5185HIV\u4e0d\u5b58\u5728\u8010\u836f\u60c5\u51b5\u3002<\/p>\n<p>\u8010\u836f\u68c0\u6d4b\u65b9\u6cd5\u5305\u62ec\u57fa\u56e0\u578b\u548c\u8868\u578b\u68c0\u6d4b\uff0c\u56fd\u5185\u5916\u591a\u4ee5\u57fa\u56e0\u578b\u68c0\u6d4b\u4e3a\u4e3b\u3002\u4e0e\u8868\u578b\u68c0\u6d4b\u76f8\u6bd4\uff0c\u57fa\u56e0\u578b\u68c0\u6d4b\u7684\u6210\u672c\u66f4\u4f4e\uff0c\u62a5\u544a\u65f6\u95f4\u66f4\u5feb\uff0c\u5bf9\u68c0\u6d4b\u91ce\u751f\u578b\u548c\u8010\u836f\u75c5\u6bd2\u6df7\u5408\u7269\u7684\u7075\u654f\u5ea6\u66f4\u9ad8\u3002\u5e94\u5728\u4ee5\u4e0b\u60c5\u51b5\u8fdb\u884cHIV\u57fa\u56e0\u578b\u8010\u836f\u68c0\u6d4b\uff1a\u5728\u542f\u52a8ART\u524d\uff1b\u6cbb\u7597\u540e\u75c5\u6bd2\u8f7d\u91cf\u4e0b\u964d\u4e0d\u7406\u60f3\u6216\u75c5\u6bd2\u5b66\u5931\u8d25\u9700\u8981\u6539\u53d8\u6cbb\u7597\u65b9\u6848\u65f6\u3002\u5bf9\u4e8eART\u5931\u8d25\u8005\uff0c\u8010\u836f\u68c0\u6d4b\u5e94\u5728\u672a\u505c\u7528\u6297\u75c5\u6bd2\u836f\u7269\u65f6\u8fdb\u884c\uff0c\u5982\u5df2\u505c\u836f\uff0c\u5219\u9700\u5728\u505c\u836f\u540e4\u5468\u5185\u8fdb\u884c\u8010\u836f\u68c0\u6d4b\u3002<\/p>\n<p>4 \u53d1\u75c5\u673a\u5236<\/p>\n<p>HIV\u4e3b\u8981\u4fb5\u72af\u4eba\u4f53\u7684\u514d\u75ab\u7cfb\u7edf\uff0c\u5305\u62ecCD4+T\u6dcb\u5df4\u7ec6\u80de\u3001\u5355\u6838\u5de8\u566c\u7ec6\u80de\u548c\u6811\u7a81\u72b6\u7ec6\u80de\u7b49\uff0c\u4e3b\u8981\u8868\u73b0\u4e3aCD4+T\u6dcb\u5df4\u7ec6\u80de\u6570\u91cf\u4e0d\u65ad\u51cf\u5c11\uff0c\u6700\u7ec8\u5bfc\u81f4\u4eba\u4f53\u7ec6\u80de\u514d\u75ab\u529f\u80fd\u7f3a\u9677\uff0c\u5f15\u8d77\u5404\u79cd\u673a\u4f1a\u6027\u611f\u67d3\u548c\u80bf\u7624\u7684\u53d1\u751f\u3002\u6b64\u5916\uff0cHIV\u611f\u67d3\u4e5f\u4f1a\u5bfc\u81f4\u5fc3\u8840\u7ba1\u75be\u75c5\uff08CVD\uff09\u3001\u9aa8\u75c5\u3001\u80be\u75c5\u548c\u809d\u529f\u80fd\u4e0d\u5168\u7b49\u75be\u75c5\u7684\u53d1\u75c5\u98ce\u9669\u589e\u52a0\u3002<\/p>\n<p>HIV\u8fdb\u5165\u4eba\u4f53\u540e\uff0c\u572824~48 h\u5230\u8fbe\u5c40\u90e8\u6dcb\u5df4\u7ed3\uff0c5~10 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000\u62f7\u8d1d\/mL\uff09\uff1b\uff082\uff09\u6709\u6d41\u884c\u75c5\u5b66\u53f2\u6216\u827e\u6ecb\u75c5\u76f8\u5173\u4e34\u5e8a\u8868\u73b0\uff0c\u4e24\u6b21HIV\u6838\u9178\u68c0\u6d4b\u5747\u4e3a\u9633\u6027\uff1b\uff083\uff09HIV\u5206\u79bb\u8bd5\u9a8c\u9633\u6027\u3002<\/p>\n<p>18\u6708\u9f84\u53ca\u4ee5\u4e0b\u513f\u7ae5\uff0c\u7b26\u5408\u4e0b\u5217\u4e00\u9879\u8005\u5373\u53ef\u8bca\u65adHIV\u611f\u67d3\uff1a\uff081\uff09\u4e3aHIV\u611f\u67d3\u6bcd\u4eb2\u6240\u751f\u548c\u4e24\u6b21HIV\u6838\u9178\u68c0\u6d4b\u5747\u4e3a\u9633\u6027\uff08\u7b2c\u4e8c\u6b21\u68c0\u6d4b\u9700\u5728\u51fa\u751f4\u5468\u540e\u91c7\u6837\u8fdb\u884c\uff09\uff1b\uff082\uff09\u6709\u533b\u6e90\u6027\u66b4\u9732\u53f2\uff0cHIV\u5206\u79bb\u8bd5\u9a8c\u7ed3\u679c\u9633\u6027\u6216\u4e24\u6b21HIV\u6838\u9178\u68c0\u6d4b\u5747\u4e3a\u9633\u6027\uff1b\uff083\uff09\u4e3aHIV\u611f\u67d3\u6bcd\u4eb2\u6240\u751f\u548cHIV\u5206\u79bb\u8bd5\u9a8c\u9633\u6027\u3002<\/p>\n<p>6.1\u3000HIV\u611f\u67d3\u65e9\u671f\u7684\u8bca\u65ad\u6807\u51c6\u3000\u4e5f\u5373\u662fI\u671f\uff0c\u6210\u4eba\u53ca15\u5c81\uff08\u542b15\u5c81\uff09\u4ee5\u4e0a\u9752\u5c11\u5e74HIV\u611f\u67d3\u8005\uff0c\u7b26\u5408\u4e0b\u5217\u4e00\u9879\u5373\u53ef\u8bca\u65ad\uff1a\uff081\uff093~6\u4e2a\u6708\u5185\u6709\u6d41\u884c\u75c5\u5b66\u53f2\u548c\/\u6216\u6709\u6025\u6027HIV\u611f\u67d3\u7efc\u5408\u5f81\u548c\/\u6216\u6709\u6301\u7eed\u6027\u5168\u8eab\u6027\u6dcb\u5df4\u817a\u75c5\uff08PGL\uff09\uff1b\uff082\uff09\u6297\u4f53\u7b5b\u67e5\u8bd5\u9a8c\u65e0\u53cd\u5e94\uff0c\u4e24\u6b21\u6838\u9178\u68c0\u6d4b\u5747\u4e3a\u9633\u6027\uff1b\uff083\uff09\u4e00\u5e74\u5185\u51fa\u73b0HIV\u8840\u6e05\u6297\u4f53\u9633\u8f6c\u300215 \u5c81\u4ee5\u4e0b\u513f\u7ae5HIV\u611f\u67d3\u8005I\u671f\u7684\u8bca\u65ad\u9700\u6839\u636eCD4+T\u6dcb\u5df4\u7ec6\u80de\u6570\u548c\u76f8\u5173\u4e34\u5e8a\u8868\u73b0\u6765\u8fdb\u884c\u3002<\/p>\n<p>6.2\u3000HIV\u611f\u67d3\u4e2d\u671f\u7684\u8bca\u65ad\u6807\u51c6\u3000\u4e5f\u5373\u662f\u2161\u671f\uff0c\u6210\u4eba\u53ca15\u5c81\uff08\u542b15\u5c81\uff09\u4ee5\u4e0a\u9752\u5c11\u5e74HIV\u611f\u67d3\u8005\uff0c\u7b26\u5408\u4e0b\u5217\u4e00\u9879\u5373\u53ef\u8bca\u65ad\uff1a\uff081\uff09CD4+T \u6dcb\u5df4\u7ec6\u80de\u8ba1\u6570\u4e3a200~500\u4e2a\/\u03bcL\uff1b\uff082\uff09\u65e0\u75c7\u72b6\u6216\u7b26\u5408\u65e0\u75c7\u72b6\u671f\u76f8\u5173\u4e34\u5e8a\u8868\u73b0\u300215\u5c81\u4ee5\u4e0b\u513f\u7ae5HIV\u611f\u67d3\u8005\u2161\u671f\u7684\u8bca\u65ad\u9700\u6839\u636eCD4+T\u6dcb\u5df4\u7ec6\u80de\u6570\u548c\u76f8\u5173\u4e34\u5e8a\u8868\u73b0\u6765\u8fdb\u884c\u3002<\/p>\n<p>6.3\u3000\u827e\u6ecb\u75c5\u671f\u7684\u8bca\u65ad\u6807\u51c6\u3000\u4e5f\u5373\u662f\u2162\u671f\uff0c\u4e5f\u79f0\u4e3aAIDS\u671f\uff0c\u6210\u4eba\u53ca15\u5c81\uff08\u542b15\u5c81\uff09\u4ee5\u4e0a\u9752\u5c11\u5e74\uff0cHIV\u611f\u67d3\u52a0\u4e0b\u8ff0\u5404\u9879\u4e2d\u7684\u4efb\u4f55\u4e00\u9879\uff0c\u5373\u53ef\u786e\u8bca\u4e3a\u827e\u6ecb\u75c5\u671f\uff1b\u6216\u8005\u786e\u8bcaHIV\u611f\u67d3\uff0c\u4e14CD4+T\u6dcb\u5df4\u7ec6\u80de\u6570&lt;200\u4e2a\/\u03bcL\uff0c\u53ef\u8bca\u65ad\u4e3a\u827e\u6ecb\u75c5\u671f\u3002<\/p>\n<p>\uff081\uff09\u4e0d\u660e\u539f\u56e0\u7684\u6301\u7eed\u4e0d\u89c4\u5219\u53d1\u70ed38 \u2103\u4ee5\u4e0a\uff0c&gt;1\u4e2a\u6708\uff1b<\/p>\n<p>\uff082\uff09\u8179\u6cfb\uff08\u5927\u4fbf\u6b21\u6570\u591a\u4e8e3\u6b21\/\u65e5\uff09\uff0c&gt;1\u4e2a\u6708\uff1b<\/p>\n<p>\uff083\uff096\u4e2a\u6708\u4e4b\u5185\u4f53\u91cd\u4e0b\u964d10\uff05\u4ee5\u4e0a\uff1b<\/p>\n<p>\uff084\uff09\u53cd\u590d\u53d1\u4f5c\u7684\u53e3\u8154\u771f\u83cc\u611f\u67d3\uff1b<\/p>\n<p>\uff085\uff09\u53cd\u590d\u53d1\u4f5c\u7684\u5355\u7eaf\u75b1\u75b9\u75c5\u6bd2\u611f\u67d3\u6216\u5e26\u72b6\u75b1\u75b9\u75c5\u6bd2\u611f\u67d3\uff1b<\/p>\n<p>\uff086\uff09\u80ba\u5b62\u5b50\u83cc\u80ba\u708e\uff08PCP\uff09\uff1b<\/p>\n<p>\uff087\uff09\u53cd\u590d\u53d1\u751f\u7684\u7ec6\u83cc\u6027\u80ba\u708e\uff1b<\/p>\n<p>\uff088\uff09\u6d3b\u52a8\u6027\u7ed3\u6838\u75c5\u6216\u975e\u7ed3\u6838\u5206\u679d\u6746\u83cc\u75c5\uff1b<\/p>\n<p>\uff089\uff09\u6df1\u90e8\u771f\u83cc\u611f\u67d3\uff1b<\/p>\n<p>\uff0810\uff09\u4e2d\u67a2\u795e\u7ecf\u7cfb\u7edf\u5360\u4f4d\u6027\u75c5\u53d8\uff1b<\/p>\n<p>\uff0811\uff09\u4e2d\u9752\u5e74\u4eba\u51fa\u73b0\u75f4\u5446\uff1b<\/p>\n<p>\uff0812\uff09\u6d3b\u52a8\u6027\u5de8\u7ec6\u80de\u75c5\u6bd2\uff08CMV\uff09\u611f\u67d3\uff1b<\/p>\n<p>\uff0813\uff09\u5f13\u5f62\u866b\u8111\u75c5\uff1b<\/p>\n<p>\uff0814\uff09\u9a6c\u5c14\u5c3c\u83f2\u7bee\u72b6\u83cc\u75c5\uff1b<\/p>\n<p>\uff0815\uff09\u53cd\u590d\u53d1\u751f\u7684\u8d25\u8840\u75c7\uff1b<\/p>\n<p>\uff0816\uff09\u5361\u6ce2\u897f\u8089\u7624\u3001\u6dcb\u5df4\u7624\u3002<\/p>\n<p>15\u5c81\u4ee5\u4e0b\u513f\u7ae5\u7b26\u5408\u4e0b\u5217\u4e00\u9879\u8005\u5373\u53ef\u8bca\u65ad\u4e3a\u827e\u6ecb\u75c5\u671f\uff1aHIV\u611f\u67d3\u548cCD4+T\u6dcb\u5df4\u7ec6\u80de\u767e\u5206\u6bd4&lt;25\uff05\uff08&lt;12\u6708\u9f84\uff09\u3001\u6216&lt;20\uff05\uff0812~36\u6708\u9f84\uff09\u3001\u6216&lt;15\uff05\uff0837~60\u6708\u9f84\uff09\u3001\u6216CD4+T\u6dcb\u5df4\u7ec6\u80de\u8ba1\u6570&lt;200\u4e2a\/\u03bcL\uff085~l4\u5c81\uff09\uff1bHIV\u611f\u67d3\u548c\u4f34\u6709\u81f3\u5c11\u4e00\u79cd\u513f\u7ae5AIDS\u6307\u5f81\u6027\u75be\u75c5\u3002<\/p>\n<p>7\u3000\u5e38\u89c1\u673a\u4f1a\u6027\u611f\u67d3<\/p>\n<p>7.1\u3000PCP<\/p>\n<p>7.1.1\u3000\u8bca\u65ad\u3000\uff081\uff09\u4e9a\u6025\u6027\u8d77\u75c5\uff0c\u547c\u5438\u56f0\u96be\u9010\u6e10\u52a0\u91cd\uff0c\u4f34\u6709\u53d1\u70ed\u3001\u5e72\u54b3\u3001\u80f8\u95f7\uff0c\u75c7\u72b6\u9010\u6e10\u52a0\u91cd\uff0c\u4e25\u91cd\u8005\u53d1\u751f\u547c\u5438\u7a98\u8feb\uff1b\uff082\uff09\u80ba\u90e8\u9633\u6027\u4f53\u5f81\u5c11\uff0c\u6216\u53ef\u95fb\u53ca\u5c11\u91cf\u6563\u5728\u7684\u5e72\u6e7f\u5570\u97f3\uff0c\u4f53\u5f81\u4e0e\u75be\u75c5\u75c7\u72b6\u7684\u4e25\u91cd\u7a0b\u5ea6\u5f80\u5f80\u4e0d\u6210\u6bd4\u4f8b\uff1b\uff083\uff09\u80f8\u90e8X\u7ebf\u68c0\u67e5\u53ef\u89c1\u53cc\u80ba\u4ece\u80ba\u95e8\u5f00\u59cb\u7684\u5f25\u6f2b\u6027\u7f51\u72b6\u7ed3\u8282\u6837\u95f4\u8d28\u6d78\u6da6\uff0c\u80ba\u90e8CT\u663e\u793a\u53cc\u80ba\u6bdb\u73bb\u7483\u72b6\u6539\u53d8\uff0c13%~18%\u7684\u60a3\u8005\u540c\u65f6\u5408\u5e76\u7ec6\u83cc\u6216\u5206\u679d\u6746\u83cc\u611f\u67d3\uff0c\u80ba\u90e8\u5f71\u50cf\u5b66\u53ef\u6709\u76f8\u5e94\u8868\u73b0\uff1b\uff084\uff09\u8840\u6c14\u5206\u6790\u793a\u4f4e\u6c27\u8840\u75c7\uff0c\u4e25\u91cd\u75c5\u4f8b\u52a8\u8109\u8840\u6c27\u5206\u538b\uff08PaO2\uff09\u660e\u663e\u964d\u4f4e\uff0c\u5e38\u572860 mmHg\uff081 mmHg=0.133 kPa\uff09\u4ee5\u4e0b\uff1b\uff085\uff09\u8840\u4e73\u9178\u8131\u6c22\u9176\u5e38&gt;500 mg\/dL\uff1b\u8840\u6d46\u4e2d\uff081\uff0c3\uff09-\u03b2-D\u8461\u805a\u7cd6\uff081\uff0c3-\u03b2-D-glucan\uff0cBDG\uff09\u6c34\u5e73\u660e\u663e\u9ad8\u4e8e\u6b63\u5e38\u503c\uff1b\uff086\uff09\u786e\u8bca\u4f9d\u9760\u75c5\u539f\u5b66\u68c0\u67e5\u5982\u75f0\u6db2\u6216\u652f\u6c14\u7ba1\u80ba\u6ce1\u704c\u6d17\/\u80ba\u7ec4\u7ec7\u6d3b\u68c0\u7b49\u53d1\u73b0\u80ba\u5b62\u5b50\u83cc\u7684\u5305\u56ca\u6216\u6ecb\u517b\u4f53\u3002PCR\u4e5f\u662f\u4e00\u79cd\u53ef\u4f9b\u9009\u62e9\u7684\u8bca\u65ad\u65b9\u6cd5\u3002<\/p>\n<p>7.1.2\u3000\u6cbb\u7597\u3000\uff081\uff09\u5bf9\u75c7\u6cbb\u7597\uff1a\u5367\u5e8a\u4f11\u606f\uff0c\u7ed9\u4e88\u5438\u6c27\uff0c\u6ce8\u610f\u6c34\u548c\u7535\u89e3\u8d28\u5e73\u8861\u3002\uff082\uff09\u75c5\u539f\u6cbb\u7597\uff1a\u9996\u9009\u590d\u65b9\u78fa\u80fa\u7532\u5641\u5511\uff08SMZ-TMP\uff09\uff0c\u8f7b-\u4e2d\u5ea6\u60a3\u8005\u53e3\u670dTMP 15~20 mg\/\uff08kg\u00b7d\uff09\uff0cSMZ 75~100 mg\/\uff08kg\u00b7d\uff09\uff0c\u52063~4\u6b21\u7528\uff0c\u7597\u7a0b21 d\uff0c\u5fc5\u8981\u65f6\u53ef\u5ef6\u957f\u7597\u7a0b\u3002\u91cd\u75c7\u60a3\u8005\u7ed9\u4e88\u9759\u8109\u7528\u836f\uff0c\u5242\u91cf\u540c\u53e3\u670d\u3002SMZ-TMP\u8fc7\u654f\u8005\u53ef\u8bd5\u884c\u8131\u654f\u7597\u6cd5\u3002\u66ff\u4ee3\u6cbb\u7597\uff1a\u514b\u6797\u9709\u7d20600~900 mg\uff0c\u9759\u8109\u6ef4\u6ce8\uff0c1\u6b21\/8 h\uff0c\u6216450 mg\u53e3\u670d\uff0c1\u6b21\/6 h\uff1b\u8054\u5408\u5e94\u7528\u4f2f\u6c28\u55b915~30 mg\uff0c\u53e3\u670d\uff0c1\u6b21\/d\uff0c \u7597\u7a0b21 d\u3002\u6c28\u82ef\u781c100 mg\uff0c\u53e3\u670d\uff0c1\u6b21\/d\uff1b\u8054\u5408\u5e94\u7528\u7532\u6c27\u82c4\u80fa\u5627\u5576200~400 mg\uff0c\u53e3\u670d\uff0c2~3\u6b21\/d\uff0c\u7597\u7a0b21 d\u3002\u6216\u55b7\u4ed6\u8112\uff0c3~4 mg\/kg\uff0c1\u6b21\/d\uff0c\u7f13\u6162\u9759\u8109\u6ef4\u6ce8\uff0860 min\u4ee5\u4e0a\uff09\uff0c\u7597\u7a0b21 d\u3002\uff083\uff09\u6fc0\u7d20\u6cbb\u7597\uff1a\u4e2d\u91cd\u5ea6\u60a3\u8005\uff08PaO2&lt;70 mmHg\u6216\u80ba\u6ce1-\u52a8\u8109\u8840\u6c27\u5206\u538b\u5dee&gt;35 mmHg\uff09\uff0c\u65e9\u671f\uff0872 h\u5185\uff09\u53ef\u5e94\u7528\u6fc0\u7d20\u6cbb\u7597\uff0c\u6cfc\u5c3c\u677e40 mg\uff0c2\u6b21\/d\uff0c\u53e3\u670d5 d\uff0c\u653920 mg\uff0c2\u6b21\/d\uff0c5 d\uff0c20 mg\uff0c1\u6b21\/d\uff0c\u81f3\u7597\u7a0b\u7ed3\u675f\uff1b\u9759\u8109\u7528\u7532\u57fa\u6cfc\u5c3c\u677e\u9f99\u5242\u91cf\u4e3a\u4e0a\u8ff0\u6cfc\u5c3c\u677e\u768475%\u3002\uff084\uff09\u8f85\u52a9\u901a\u6c14\uff1a\u5982\u60a3\u8005\u8fdb\u884c\u6027\u547c\u5438\u56f0\u96be\u660e\u663e\uff0c\u53ef\u7ed9\u4e88\u8f85\u52a9\u901a\u6c14\u3002\uff085\uff09ART\uff1a\u5c3d\u65e9\u8fdb\u884cART\uff0c\u901a\u5e38\u5728\u542f\u52a8\u6297PCP\u6cbb\u7597\u540e2\u5468\u5185\u8fdb\u884c\u3002<\/p>\n<p>7.1.3\u3000\u9884\u9632\u3000\uff081\uff09\u9884\u9632\u6307\u5f81\uff1a 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mg\/\uff08kg\u00b7d\uff09\uff0c\u808c\u8089\u6ce8\u5c04\uff0c1\u6b21\/d\uff3d\u6216\u55b9\u8bfa\u916e\u7c7b\u6297\u83cc\u836f\u7269\u5982\u5de6\u6c27\u6c1f\u6c99\u661f\u6216\u83ab\u897f\u6c99\u661f\u3002\u7597\u7a0b\u901a\u5e38\u81f3\u5c1112\u4e2a\u6708\u3002\u5176\u4ed6NTM\u611f\u67d3\u7684\u6cbb\u7597\u9700\u6839\u636e\u5177\u4f53\u9274\u5b9a\u7684\u83cc\u79cd\u4ee5\u53ca\u836f\u654f\u68c0\u6d4b\u7ed3\u679c\u91c7\u53d6\u76f8\u5e94\u7684\u6cbb\u7597\u63aa\u65bd\uff3b21\uff3d\u3002\u5728\u6297MAC\u6cbb\u7597\u5f00\u59cb2\u5468\u540e\u5c3d\u5feb\u542f\u52a8ART\u3002<\/p>\n<p>7.3.3 \u9884\u9632\u3000\u4e00\u7ea7\u9884\u9632\uff1a\u7acb\u5373\u542f\u52a8ART\u7684\u60a3\u8005\uff0c\u4e0d\u63a8\u8350\u4e00\u7ea7\u9884\u9632\uff1b\u5982\u6ca1\u6709\u63a5\u53d7ART\u6216\u5df2\u63a5\u53d7ART\uff0c\u4f46HIV RNA\u672a\u88ab\u5b8c\u5168\u6291\u5236\uff0c\u4e14\u76ee\u524d\u8fd8\u6ca1\u6709\u6709\u6548\u7684ART\uff0cCD4+T\u6dcb\u5df4\u7ec6\u80de\u8ba1\u6570&lt;50\u4e2a\/\u03bcL\uff0c\u6392\u9664\u64ad\u6563\u6027MAC\u7684\u60a3\u8005\uff0c\u5e94\u4e88\u4ee5\u4e00\u7ea7\u9884\u9632\uff3b13\uff3d\u3002\u4e00\u7ea7\u9884\u9632\u7684\u65b9\u6848\u662f\u514b\u62c9\u9709\u7d20500 mg\/\u6b21\uff0c2 \u6b21\/d\uff1b\u6216\u963f\u5947\u9709\u7d20\uff0c1 200 mg\/\u5468\u3002\u5982\u60a3\u8005\u4e0d\u80fd\u8010\u53d7\u514b\u62c9\u9709\u7d20\u548c\u963f\u5947\u9709\u7d20\uff0c\u6392\u9664\u6d3b\u52a8\u6027\u7ed3\u6838\u75c5\u540e\u53ef\u4ee5\u9009\u62e9\u5229\u798f\u5e03\u6c40\u8fdb\u884c\u9884\u9632\u6cbb\u7597\uff0c\u5e38\u89c4\u5242\u91cf\u4e3a300 mg\/\u6b21\uff0c1\u6b21\/d\u3002\u6ca1\u542f\u52a8ART\u7684\u60a3\u8005\u4e00\u65e6\u542f\u52a8\u4e86\u6709\u6548\u7684ART\uff0c\u5373\u53ef\u505c\u6b62\u9884\u9632\u7528\u836f\u3002\u4e8c\u7ea7\u9884\u9632\uff1aMAC\u611f\u67d3\u8005\u5728\u5b8c\u6210\u89c4\u8303\u7684\u6cbb\u7597\u540e\uff0c\u9700\u8981\u957f\u671f\u7ef4\u6301\u6cbb\u7597\uff08\u4e8c\u7ea7\u9884\u9632\uff09\u76f4\u81f3\u60a3\u8005CD4+T\u6dcb\u5df4\u7ec6\u80de\u8ba1\u6570&gt;100\u4e2a\/\u03bcL\uff0c\u5e76\u6301\u7eed&gt;6\u4e2a\u6708\u65f6\u4e3a\u6b62\u3002\u4e8c\u7ea7\u9884\u9632\u7684\u65b9\u6848\u4e0e\u521d\u59cb\u6cbb\u7597\u65b9\u6848\u4e00\u81f4\u3002<\/p>\n<p>7.4\u3000CMV\u611f\u67d3\u3000CMV\u611f\u67d3\u662fHIV\/AIDS\u60a3\u8005\u6700\u5e38\u89c1\u7684\u75b1\u75b9\u75c5\u6bd2\u611f\u67d3\uff0c\u53ef\u5206\u4e3aCMV\u8840\u75c7\u548c\u5668\u5b98\u53d7\u7d2f\u7684CMV\u75c5\u3002CMV\u53ef\u4fb5\u72af\u60a3\u8005\u591a\u4e2a\u5668\u5b98\u7cfb\u7edf\uff0c\u5305\u62ec\u773c\u3001\u80ba\u3001\u6d88\u5316\u7cfb\u7edf\u3001\u4e2d\u67a2\u795e\u7ecf\u7cfb\u7edf\u7b49\uff0c\u5176\u4e2dCMV\u89c6\u7f51\u819c\u8109\u7edc\u819c\u708e\u6700\u5e38\u89c1\u3002<\/p>\n<p>7.4.1 CMV\u89c6\u7f51\u819c\u708e\u7684\u8bca\u65ad\u548c\u6cbb\u7597\u3000\u8bca\u65ad\uff1a\u5178\u578b\u7684\u75c7\u72b6\u5305\u62ec\u98de\u868a\u75c7\u3001\u6f02\u6d6e\u7269\u3001\u76f2\u70b9\u6216\u5916\u5468\u89c6\u91ce\u7f3a\u635f\uff0c\u60a3\u8005\u5e38\u8868\u73b0\u4e3a\u5feb\u901f\u89c6\u529b\u4e0b\u964d\uff0c\u773c\u5e95\u68c0\u67e5\u8868\u73b0\u4e3a\u201c\u756a\u8304\u7092\u9e21\u86cb\u6837\u201d\u6539\u53d8\uff0c\u6cbf\u8840\u7ba1\u5206\u5e03\u7684\u6d53\u539a\u7684\u9ec4\u767d\u8272\u89c6\u7f51\u819c\u635f\u4f24\uff0c\u4f34\u6216\u4e0d\u4f34\u89c6\u7f51\u819c\u5185\u51fa\u8840\uff1b80%\u7684CMV\u89c6\u7f51\u819c\u708e\u60a3\u8005\u73bb\u7483\u4f53\u6db2\u4e2d\u53ef\u68c0\u6d4b\u5230CMV DNA\uff1b\u786e\u8bca\u6709\u8d56\u4e8e\u773c\u5e95\u955c\u68c0\u67e5\u3002<\/p>\n<p>\u6cbb\u7597\uff1a\uff081\uff09\u63a8\u8350\u7684\u5168\u8eab\u6cbb\u7597\u65b9\u6848\uff1a\u2460\u66f4\u6614\u6d1b\u97e65 mg\/kg\u9759\u8109\u6ef4\u6ce8\uff0c1\u6b21\/12 h\uff0c\u8fde\u7eed14~21 d\uff0c\u7136\u540e5 mg\/kg\u9759\u8109\u6ef4\u6ce8\uff0c1\u6b21\/d\uff1b\u2461\u66f4\u6614\u6d1b\u97e65 mg \/kg\u9759\u8109\u6ef4\u6ce8\uff0c1\u6b21\/12 h\uff0c\u8fde\u7eed14~21 d\uff0c\u7136\u540e\u7f2c\u66f4\u6614\u6d1b\u97e6900 mg\uff0c\u53e3\u670d\uff0c1\u6b21\/d\uff0c\u6216\u66f4\u6614\u6d1b\u97e61.0\uff0c\u53e3\u670d\uff0c3\u6b21\/d\uff1b\u2462\u7f2c\u66f4\u6614\u6d1b\u97e6900 mg\uff0c\u53e3\u670d\uff0c1\u6b21\/12 h\uff0c\u6cbb\u759714~21 d\uff0c\u7136\u540e900 mg\uff0c1\u6b21\/d\uff0c\u6216\u66f4\u6614\u6d1b\u97e61.0\uff0c\u53e3\u670d\uff0c3\u6b21\/d\u3002\u66ff\u4ee3\u6cbb\u7597\u65b9\u6848\u53ef\u9009\u62e9\uff1a\u81a6\u78f7\u94be\u9178\u94a060 mg\/kg\u9759\u8109\u6ef4\u6ce8\uff0c1\u6b21\/8 h \u621690 mg\/kg\u9759\u8109\u6ef4\u6ce8\uff0c1\u6b21\/12 h\uff0c14~21 d\uff0c\u800c\u540e\u6539\u4e3a90~120 mg\/kg\u9759\u8109\u6ef4\u6ce8\uff0c1\u6b21\/d\uff0c\u6216\u66f4\u6614\u6d1b\u97e61.0\uff0c\u53e3\u670d\uff0c3\u6b21\/d\u3002\uff082\uff09\u5c40\u90e8\u6cbb\u7597\uff1a\u9700\u8981\u773c\u79d1\u533b\u751f\u53c2\u4e0e\uff0c\u73bb\u7483\u4f53\u5185\u6ce8\u5c04\u66f4\u6614\u6d1b\u97e6\uff082 mg\/\u9488\uff09\u6216\u81a6\u7532\u9178\uff082.4 mg\/\u9488\uff09\uff0c\u6bcf\u5468\u91cd\u590d\u4e00\u6b21\uff0c\u7597\u7a0b\u5230\u89c6\u7f51\u819c\u75c5\u53d8\u88ab\u63a7\u5236\u3001\u75c5\u53d8\u4e0d\u6d3b\u52a8\u4e3a\u6b62\u3002<\/p>\n<p>7.4.2 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DNA\u7684\u68c0\u6d4b\uff0c\u654f\u611f\u6027\u4e3a80%\uff0c\u7279\u5f02\u6027\u4e3a90%\u3002\u6cbb\u7597\u4e0a\u91c7\u7528\u66f4\u6614\u6d1b\u97e6\u8054\u5408\u81a6\u7532\u9178\u94a0\u6cbb\u75973~6\u5468\uff0c\u5242\u91cf\u540c\u4e0a\uff0c\u540e\u7ef4\u6301\u6cbb\u7597\u76f4\u81f3\u8111\u810a\u6db2CMV\u5b9a\u91cf\u8f6c\u9634\uff0c\u5177\u4f53\u5e94\u4e2a\u4f53\u5316\u6cbb\u7597\u3002<\/p>\n<p>7.4.3 ART\u3000\u5728\u6297CMV\u6cbb\u7597\u5f00\u59cb2\u5468\u5185\u5c3d\u5feb\u542f\u52a8ART\u3002<\/p>\n<p>7.4.4 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g\uff0c3\u6b21\/d\uff0c\u53e3\u670d\uff09\u6765\u9884\u9632\u590d\u53d1\u3002\u5728\u7ecfART\u540eCD4+T\u6dcb\u5df4\u7ec6\u80de\u8ba1\u6570&gt;100\u4e2a\/\u03bcL\u4e14\u6301\u7eed3~6\u4e2a\u6708\u4ee5\u4e0a\u65f6\u53ef\u4ee5\u8003\u8651\u505c\u6b62\u9884\u9632\u7528\u836f\uff0c\u800cCMV\u80a0\u708e\u3001CMV\u80ba\u708e\u4ee5\u53caCMV\u795e\u7ecf\u75c5\u53d8\u4e0d\u4e3b\u5f20\u4e8c\u7ea7\u9884\u9632\u3002<\/p>\n<p>7.5\u3000\u5355\u7eaf\u75b1\u75b9\u548c\u6c34\u75d8\u5e26\u72b6\u75b1\u75b9\u75c5\u6bd2\u611f\u67d3<\/p>\n<p>7.5.1\u3000\u8bca\u65ad\u3000\u6839\u636e\u5178\u578b\u7684\u4e34\u5e8a\u8868\u73b0\uff0c\u5355\u7eaf\u75b1\u75b9\u548c\u5e26\u72b6\u75b1\u75b9\u7684\u8bca\u65ad\u5e76\u4e0d\u56f0\u96be\u3002\u53ef\u901a\u8fc7\u6536\u96c6\u75b1\u6db2\uff0c\u7528PCR\u68c0\u6d4b\u3001\u75c5\u6bd2\u57f9\u517b\u6765\u8fdb\u884c\u786e\u8bca\u3002<\/p>\n<p>7.5.2 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mg\uff0c3\u6b21\/d\uff0c\u635f\u4f24\u5b8c\u5168\u6108\u5408\u540e\u505c\u836f\u3002\uff083\uff09\u963f\u6614\u6d1b\u97e6\u6cbb\u7597\u62b5\u6297\uff08\u8010\u836f\uff09\u7684\u5355\u7eaf\u75b1\u75b9\uff1a\u63a8\u8350\u81a6\u7532\u9178\u94a0\u9759\u8109\u6ef4\u6ce8\uff0c\u6bcf\u6b2140 mg\/kg\uff0c1\u6b21\/8 h\u62161\u6b21\/12 h\uff0c\u76f4\u5230\u6cbb\u6108\u3002\uff084\uff09\u5c40\u90e8\u76ae\u80a4\u5e26\u72b6\u75b1\u75b9\uff1a\u963f\u6614\u6d1b\u97e6\u9759\u8109\u6ef4\u6ce8\uff0c\u6bcf\u6b215~10 mg\/kg\uff0c1 \u6b21\/8 h\uff0c\u7597\u7a0b7 d\u3002\uff085\uff09\u4e25\u91cd\u7684\u76ae\u80a4\u9ecf\u819c\u5e26\u72b6\u75b1\u75b9\uff1a\u81a6\u7532\u9178\u94a0\u9759\u8109\u6ef4\u6ce8\uff0c\u6bcf\u6b2140 mg\/kg\uff0c1 \u6b21\/8 h\u62161 \u6b21\/12 h\u6216\u963f\u6614\u6d1b\u97e6\u9759\u8109\u6ef4\u6ce8\uff0c\u6bcf\u6b2110 mg\/kg\uff0c1 \u6b21\/8 h\uff0c\u75c5\u60c5\u7a33\u5b9a\u540e\u66f4\u6362\u4f10\u6614\u6d1b\u97e6\u53e3\u670d\uff0c\u6bcf\u6b211.0\uff0c3 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\u6b21\/d\u3002<\/p>\n<p>7.6\u3000\u5f13\u5f62\u866b\u8111\u75c5<\/p>\n<p>7.6.1\u3000\u8bca\u65ad\u3000\u4e34\u5e8a\u8868\u73b0\u4e3a\u53d1\u70ed\u4f34\u5c40\u7076\u6216\u5f25\u6f2b\u6027\u4e2d\u67a2\u795e\u7ecf\u7cfb\u7edf\u635f\u5bb3\u3002\u5934\u9885CT\u5448\u5355\u4e2a\u6216\u591a\u4e2a\u4f4e\u5bc6\u5ea6\u75c5\u7076\uff0c\u589e\u5f3a\u626b\u63cf\u5448\u73af\u72b6\u6216\u7ed3\u8282\u6837\u589e\u5f3a\uff0c\u5468\u56f4\u4e00\u822c\u6709\u6c34\u80bf\u5e26\u3002MRI\u8868\u73b0\u4e3a\u9885\u5185\u591a\u53d1\u957fT1\u548c\u957fT2\u4fe1\u53f7\u3002\u6b63\u7535\u5b50\u53d1\u5c04\u626b\u63cf\uff08PET\uff09\u68c0\u6d4b\u6709\u52a9\u4e8e\u4e34\u5e8a\u8bca\u65ad\u3002\u514d\u75ab\u5b66\u65b9\u6cd5\u4e3b\u8981\u68c0\u6d4b\u8840\u6e05\u6216\u7ec4\u7ec7\u6db2\u7b49\u6807\u672c\u4e2d\u7684\u5f13\u5f62\u866b\u6297\u4f53\uff0c\u53ef\u4ee5\u4f5c\u4e3a\u5f13\u5f62\u866b\u75c5\u7684\u8f85\u52a9\u8bca\u65ad\u3002\u786e\u8bca\u4f9d\u8d56\u8111\u7ec4\u7ec7\u6d3b\u68c0\u3002<\/p>\n<p>7.6.2 \u6cbb\u7597\u3000\uff081\uff09\u75c5\u539f\u6cbb\u7597\uff1a\u9996\u9009\u4e59\u80fa\u5627\u5576\uff08\u8d1f\u8377\u91cf100 mg\uff0c\u53e3\u670d\uff0c2 \u6b21\/d\uff0c\u6b64\u540e50~75 mg\/d\u7ef4\u6301\uff09+\u78fa\u80fa\u5627\u5576\uff081~1.5 g\uff0c\u53e3\u670d\uff0c4 \u6b21\/d\uff09\u3002\uff082\uff09\u66ff\u4ee3\u6cbb\u7597\uff1aSMZ-TMP\uff083\u7247\uff0c\u6bcf\u65e53\u6b21\u53e3\u670d\uff09\u8054\u5408\u514b\u6797\u9709\u7d20\uff08600 mg\/\u6b21\uff0c\u9759\u8109\u7ed9\u836f\uff0c\u6bcf6 h\u7ed9\u836f\u4e00\u6b21\uff09\u6216\u963f\u5947\u9709\u7d20\uff080.5 g\/d\uff09\u3002\u7597\u7a0b\u81f3\u5c116\u5468\u3002\uff083\uff09\u5bf9\u75c7\u6cbb\u7597\uff1a\u964d\u9885\u538b\u3001\u6297\u60ca\u53a5\u3001\u6297\u766b\u75eb\u7b49\u3002<\/p>\n<p>7.6.3 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g\/d\uff09\u9884\u9632\uff0c\u76f4\u81f3CD4+T\u6dcb\u5df4\u7ec6\u80de\u589e\u52a0\u5230&gt;200\u4e2a\/\u03bcL\u5e76\u6301\u7eed\u22656\u4e2a\u6708\u3002\u4e00\u65e6CD4+T\u6dcb\u5df4\u7ec6\u80de\u6570\u4e0b\u964d\u5230&lt;200\u4e2a\/\u03bcL\uff0c\u9700\u91cd\u542f\u9884\u9632\u7528\u836f\u3002<\/p>\n<p>7.7\u3000\u771f\u83cc\u611f\u67d3<\/p>\n<p>7.7.1\u3000\u8bca\u65ad\u3000\u4e34\u5e8a\u4e0a\u5e38\u89c1\u7684\u662f\u5ff5\u73e0\u83cc\u611f\u67d3\u548c\u65b0\u751f\u9690\u7403\u83cc\u611f\u67d3\uff0c\u9664\u6b64\u4e4b\u5916\u5728\u5357\u65b9\u6216\u6f6e\u6e7f\u591a\u96e8\u5730\u533a\u9a6c\u5c14\u5c3c\u83f2\u7bee\u72b6\u83cc\u4e5f\u8f83\u5e38\u89c1\uff0c\u8bca\u65ad\u4f9d\u9760\u4e34\u5e8a\u8868\u73b0\u6216\u611f\u67d3\u90e8\u4f4d\u57f9\u517b\u6216\u75c5\u7406\u53d1\u73b0\u75c5\u539f\u4f53\u3002\u65b0\u751f\u9690\u7403\u83cc\u611f\u67d3\u4e3b\u8981\u53d1\u751f\u4e8eCD4+T\u6dcb\u5df4\u7ec6\u80de\u8ba1\u6570&lt;100\u4e2a\/\u03bcL\u7684\u60a3\u8005\u4e2d\uff0c\u8840\u6216\u8111\u810a\u6db2\u9690\u7403\u83cc\u4e73\u80f6\u51dd\u80f6\u5b9e\u9a8c\u53ef\u8f85\u52a9\u8bca\u65ad\u65b0\u751f\u9690\u7403\u83cc\u611f\u67d3\u3002\u9690\u7403\u83cc\u8111\u819c\u708e\u6216\u8111\u819c\u8111\u708e\u4e34\u5e8a\u4e0a\u4e3b\u8981\u8868\u73b0\u5305\u62ec\u53d1\u70ed\u3001\u6e10\u8fdb\u6027\u5934\u75db\u3001\u7cbe\u795e\u548c\u795e\u7ecf\u75c7\u72b6\uff1b\u9885\u5185\u538b\u589e\u9ad8\u6bd4\u8f83\u5e38\u89c1\uff0c\u60a3\u8005\u5934\u75db\u53ca\u6076\u5fc3\u5455\u5410\u8f83\u5267\u70c8\uff1b\u8111\u810a\u6db2\u6d82\u7247\u58a8\u6c41\u67d3\u8272\u955c\u68c0\u53ef\u67e5\u89c1\u9690\u7403\u83cc\u3002\u9a6c\u5c14\u5c3c\u83f2\u7bee\u72b6\u83cc\u75c5\u4e3b\u8981\u53d1\u751f\u4e8eCD4+T\u6dcb\u5df4\u7ec6\u80de\u8ba1\u6570&lt;50\u4e2a\/\u03bcL\uff0c\u8868\u73b0\u4e3a\u53d1\u70ed\u3001\u8d2b\u8840\u3001\u54b3\u55fd\u3001\u76ae\u75b9\u3001\u5168\u8eab\u6dcb\u5df4\u7ed3\u80bf\u5927\u53ca\u809d\u813e\u80bf\u5927\uff0c\u8110\u51f9\u6837\u76ae\u75b9\uff0c\u68c0\u6d4b\u9a6c\u5c14\u5c3c\u83f2\u7bee\u72b6\u83cc\u7279\u5f02\u6027\u7518\u9732\u7cd6\u86cb\u767d\uff08Mannoprotein\uff0cMp1p\uff09\u548c\u534a\u4e73\u7518\u9732\u805a\u7cd6\uff08Galactomannan\uff0c GM\uff09\u53ef\u8f85\u52a9\u5feb\u901f\u8bca\u65ad\uff3b26\uff3d\uff1b\u786e\u8bca\u4f9d\u9760\u8840\u6db2\u3001\u9aa8\u9ad3\u53ca\u5176\u4ed6\u65e0\u83cc\u4f53\u6db2\u4e2d\u57f9\u517b\u51fa\u9a6c\u5c14\u5c3c\u83f2\u7bee\u72b6\u83cc\u3002<\/p>\n<p>7.7.2 \u6cbb\u7597<\/p>\n<p>\uff081\uff09\u5ff5\u73e0\u83cc\u611f\u67d3<\/p>\n<p>\u53e3\u8154\u5ff5\u73e0\u83cc\u611f\u67d3\uff1a\u9996\u9009\u53e3\u670d\u6c1f\u5eb7\u5511100~200 mg\/d\uff0c\u51717~14 d\uff1b\u66ff\u4ee3\u7597\u6cd5\uff1a\u4f0a\u66f2\u5eb7\u5511\u53e3\u670d\u6db2200 mg\uff0c1\u6b21\/d\uff0c\u51717~14 d\uff1b\u6216\u5236\u9709\u83cc\u7d20\u5c40\u90e8\u6d82\u62b9\u52a0\u78b3\u9178\u6c22\u94a0\u6f31\u53e3\u6c34\u6f31\u53e3\u3002\u98df\u9053\u5ff5\u73e0\u83cc\u611f\u67d3\uff1a\u53e3\u670d\u6216\u9759\u8109\u6ce8\u5c04\u6c1f\u5eb7\u5511100~400 mg\/d\uff0c\u6216\u8005\u4f0a\u66f2\u5eb7\u5511\u53e3\u670d\u6db2200 mg\uff0c1\u6b21\/d\uff0c\u6216\u4f0f\u7acb\u5eb7\u5511200 mg\uff0c2\u6b21\/d\uff0c\u53e3\u670d\uff1b\u7597\u7a0b\u4e3a14~21 d\u3002\u5bf9\u4e8e\u5408\u5e76\u53e3\u54bd\u6216\u98df\u7ba1\u771f\u83cc\u611f\u67d3\u7684\u60a3\u8005\u5e94\u5c3d\u5feb\u8fdb\u884cART\uff0c\u53ef\u5728\u6297\u771f\u83cc\u611f\u67d3\u7684\u540c\u65f6\u8fdb\u884cART\u3002<\/p>\n<p>\uff082\uff09\u65b0\u751f\u9690\u7403\u83cc\u611f\u67d3<\/p>\n<p>1\uff09\u9690\u7403\u83cc\u8111\u819c\u708e\u6216\u8111\u819c\u8111\u708e<\/p>\n<p>\u75c5\u539f\u6cbb\u7597\u539f\u5219\uff1a\u5206\u8bf1\u5bfc\u671f\u3001\u5de9\u56fa\u671f\u3001\u7ef4\u6301\u671f\u4e09\u4e2a\u9636\u6bb5\u8fdb\u884c\u6cbb\u7597\uff08\u53c2\u8003\u201c\u9690\u7403\u83cc\u6027\u8111\u819c\u708e\u8bca\u6cbb\u4e13\u5bb6\u5171\u8bc6\u201d\uff09\uff08\u88681\uff09\u3002\u8bf1\u5bfc\u671f\u6cbb\u7597\u7ecf\u5178\u65b9\u6848\u4e3a\u4e24\u6027\u9709\u7d20B+5-\u6c1f\u80de\u5627\u5576\u3002\u4e24\u6027\u9709\u7d20B\u4ece0.02~0.1 mg\/\uff08kg\u00b7d\uff09\u5f00\u59cb\uff0c\u9010\u6e10\u589e\u52a0\u5242\u91cf\u81f30.5~0.7 mg\/\uff08kg\u00b7d\uff09\uff0c\u4e24\u6027\u9709\u7d20B\u4e0d\u826f\u53cd\u5e94\u8f83\u591a\uff0c\u9700\u4e25\u5bc6\u89c2\u5bdf\u3002\u8bf1\u5bfc\u6cbb\u7597\u671f\u81f3\u5c114\u5468\uff0c\u5728\u4e34\u5e8a\u75c7\u72b6\u6539\u5584\u4e0e\u8111\u810a\u6db2\u57f9\u517b\u8f6c\u9634\u540e\u6539\u4e3a\u6c1f\u5eb7\u5511\uff08600~800 mg\/d\uff09\u8fdb\u884c\u5de9\u56fa\u671f\u6cbb\u7597\uff0c\u5de9\u56fa\u6cbb\u7597\u671f\u81f3\u5c116\u5468\uff0c\u800c\u540e\u6539\u4e3a\u6c1f\u5eb7\u5511\uff08200 mg\/d\uff09\u8fdb\u884c\u7ef4\u6301\u6cbb\u7597\uff0c\u7ef4\u6301\u671f\u81f3\u5c111\u5e74\uff0c\u6301\u7eed\u81f3\u60a3\u8005\u901a\u8fc7ART\u540eCD4+T\u6dcb\u5df4\u7ec6\u80de\u8ba1\u6570&gt;100\u4e2a\/\u03bcL\u5e76\u6301\u7eed\u81f3\u5c116\u4e2a\u6708\u65f6\u53ef\u505c\u836f\u3002<\/p>\n<p>\u964d\u9885\u538b\u6cbb\u7597\uff1a\u9885\u5185\u538b\u589e\u9ad8\u8005\u9700\u8981\u79ef\u6781\u964d\u538b\u6cbb\u7597\uff0c\u5e38\u7528\u964d\u9885\u5185\u538b\u65b9\u6cd5\u6709\u836f\u7269\u964d\u538b\u3001\u8170\u7a7f\u5f15\u6d41\u3001\u8170\u5927\u6c60\u7f6e\u7ba1\u5f15\u6d41\u3001\u4fa7\u8111\u5ba4\u5916\u5f15\u6d41\u3001\u8111\u5ba4-\u8179\u8154\u5206\u6d41\u672f\u3001\u7559\u7f6eOmmaya\u56ca\uff08\u8d2e\u6db2\u56ca\uff09\u7b49\u3002\u7f6e\u7ba1\u6301\u7eed\u5916\u5f15\u6d41\u964d\u9885\u538b\u9700\u4e25\u683c\u65e0\u83cc\u64cd\u4f5c\uff0c\u52a0\u5f3a\u62a4\u7406\uff0c\u9632\u6b62\u7ee7\u53d1\u611f\u67d3\u3002<\/p>\n<p>2\uff09\u80ba\u9690\u7403\u83cc\u611f\u67d3\uff1a\u5f25\u6f2b\u6027\u80ba\u9690\u7403\u83cc\u611f\u67d3\u7684\u63a8\u8350\u6cbb\u7597\u65b9\u6848\u4e0e\u4e2d\u67a2\u795e\u7ecf\u7cfb\u7edf\u611f\u67d3\u6cbb\u7597\u65b9\u6848\u4e00\u81f4\u3002\u5c40\u7076\u6027\u80ba\u9690\u7403\u83cc\u611f\u67d3\uff1a\u6c1f\u5eb7\u5511400~800 mg\/d\u53e3\u670d10\u5468\uff0c\u800c\u540e\u6539\u4e3a200 mg\/d\u53e3\u670d\u7ef4\u6301\uff0c\u6297\u771f\u83cc\u6cbb\u7597\u7684\u603b\u7597\u7a0b\u4e3a6\u4e2a\u6708\u3002<\/p>\n<p>3\uff09\u9690\u7403\u83cc\u6297\u539f\u8840\u75c7\uff1a\u8840\u9690\u7403\u83cc\u6297\u539f\u5b9a\u6027\u68c0\u6d4b\u9633\u6027\uff0c\u5efa\u8bae\u7ed9\u4e88\u6c1f\u5eb7\u5511400~800 mg\/d\u53e3\u670d10\u5468\uff0c\u800c\u540e\u6539\u4e3a200 mg\/d\u53e3\u670d\u7ef4\u6301\uff0c\u603b\u7597\u7a0b6~12\u4e2a\u6708\u3002<\/p>\n<p>4\uff09ART\uff1a\u827e\u6ecb\u75c5\u5408\u5e76\u9690\u7403\u83cc\u80ba\u708e\u7684\u60a3\u8005\u5e94\u5728\u6297\u9690\u7403\u83cc\u6cbb\u75972\u5468\u540e\u8fdb\u884cART\u3002\u5bf9\u4e8e\u5408\u5e76\u9690\u7403\u83cc\u8111\u819c\u708e\u7684\u60a3\u8005\u8fc7\u65e9\u8fdb\u884cART\u53ef\u80fd\u4f1a\u589e\u52a0\u75c5\u6b7b\u7387\uff0c\u6545ART\u5e94\u8003\u8651\u9002\u5f53\u5ef6\u8fdf\uff0c\u4e00\u822c\u4ee5\u6b63\u89c4\u6297\u9690\u7403\u83cc\u6cbb\u75974~6\u5468\u540e\u542f\u52a8\uff1b\u4e00\u4e9b\u4e2a\u4f53\u9700\u8981\u63d0\u524d\u542f\u52a8ART\uff0c\u4f46\u4fdd\u8bc1\u8111\u810a\u6db2\u57f9\u517b\u8f6c\u9634\u540e\u542f\u52a8\u4e3a\u5b9c\u3002<\/p>\n<p>\uff083\uff09\u9a6c\u5c14\u5c3c\u83f2\u7bee\u72b6\u83cc\u75c5<\/p>\n<p>\u6297\u771f\u83cc\u6cbb\u7597\uff1a\u8bf1\u5bfc\u671f\uff1a\u4e0d\u7ba1\u75be\u75c5\u4e25\u91cd\u7a0b\u5ea6\uff0c\u9996\u9009\u4e24\u6027\u9709\u7d20B 0.5~0.7 mg\/\uff08kg\u00b7d\uff09\u6216\u4e24\u6027\u9709\u7d20B\u8102\u8d28\u4f533~5 mg\/\uff08kg\u00b7d\uff09\uff0c\u9759\u8109\u6ef4\u6ce82\u5468\uff0c\u9700\u4e25\u5bc6\u89c2\u5bdf\u4e0d\u826f\u53cd\u5e94\uff1b\u5f53\u60a3\u8005\u4e0d\u80fd\u8010\u53d7\u4e24\u6027\u9709\u7d20B\u65f6\uff0c\u53ef\u91c7\u7528\u66ff\u4ee3\u65b9\u6848\uff1a\u7b2c\u4e00\u5929\u4f0f\u7acb\u5eb7\u5511\u9759\u8109\u6ef4\u6ce8\u6216\u53e3\u670d6 mg\u00b7kg-1\uff08\u8d1f\u8377\u5242\u91cf\uff09\uff0c1\u6b21\/12 h \uff0c\u7136\u540e\u6539\u4e3a4 mg\/\u00b7kg\uff0c1\u6b21\/12 h\uff0c\u4e0d\u5c11\u4e8e2\u5468\u3002\u5de9\u56fa\u671f\uff1a\u53e3\u670d\u4f0a\u66f2\u5eb7\u5511\u6216\u4f0f\u7acb\u5eb7\u5511200 mg\uff0c1\u6b21\/12 h\uff0c\u517110\u5468\u3002\u968f\u540e\u8fdb\u884c\u4e8c\u7ea7\u9884\u9632\uff1a\u53e3\u670d\u4f0a\u66f2\u5eb7\u5511200 mg\uff0c1\u6b21\/d\uff0c\u81f3\u60a3\u8005\u901a\u8fc7ART\u540eCD4+T\u6dcb\u5df4\u7ec6\u80de\u8ba1\u6570&gt;100\u4e2a\/\u03bcL\uff0c\u5e76\u6301\u7eed\u81f3\u5c116\u4e2a\u6708\u53ef\u505c\u836f \u3002\u4e00\u65e6CD4+ 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d\u81f3\u4e4b\u540e1\u4e2a\u6708\u8fde\u7eed\u670d\u7528TDF\/FTC\uff08\u6216\u8005TDF+3TC\uff09\u8fdb\u884c\u66b4\u9732\u9884\u9632\u3002\u81ea\u7136\u53d7\u5b55\u60c5\u51b5\u4e0b\uff0cHIV\u9634\u6027\u65b9\u65e0\u4fdd\u62a4\u6027\u4ea4\u540e\u5fc5\u987b\u8fdb\u884cHIV\u6297\u4f53\u68c0\u6d4b\uff0c\u4ee5\u6392\u9664HIV\u5728\u914d\u5076\u95f4\u4f20\u64ad\u3002<\/p>\n<p>HIV\u9633\u6027\u4e00\u65b9\u63a5\u53d7ART\u4e14\u75c5\u6bd2\u8fbe\u5230\u6301\u7eed\u6291\u5236\u662fHIV\u5355\u9633\u5bb6\u5ead\u5907\u5b55\u7684\u5173\u952e\uff0c\u53e6\u5916\uff0c\u4e3a\u4e86\u63d0\u9ad8\u53d7\u5b55\u6210\u529f\u7387\uff0c\u51c6\u786e\u8ba1\u7b97\u6392\u5375\u671f\u975e\u5e38\u91cd\u8981\uff0c\u53ef\u4ee5\u5bfb\u6c42\u5987\u4ea7\u79d1\u533b\u751f\u7684\u5e2e\u52a9\u3002<\/p>\n<p>\u5982\u679c\u75c5\u6bd2\u8f7d\u91cf\u68c0\u6d4b\u53d7\u9650\u6216\u4e0d\u53ef\u53ca\u7684\u60c5\u51b5\u4e0b\uff0c\u5efa\u8bae\u8fdb\u884cART\u534a\u5e74\u4ee5\u4e0a\u518d\u8fdb\u884c\u53d7\u5b55\u3002\u8fd9\u79cd\u60c5\u51b5\u4e0b\uff0c\u5efa\u8bae\u5bfb\u6c42HIV\u9886\u57df\u4e13\u5bb6\u6307\u5bfc\uff0c\u9634\u6027\u4e00\u65b9\u9700\u8981\u670d\u7528\u66b4\u9732\u9884\u9632\u836f\u7269\u3002<\/p>\n<p>12\u3000HIV\u66b4\u9732\u5904\u7406\u4e0e\u9884\u9632\u963b\u65ad<\/p>\n<p>\u66b4\u9732\u540e\u9884\u9632\uff08PEP\uff09\u6307\u5c1a\u672a\u611f\u67d3HIV\u7684\u4eba\u7fa4\uff0c\u5728\u66b4\u9732\u4e8e\u9ad8\u611f\u67d3\u98ce\u9669\u540e\uff0c\u5982\u4e0eHIV\u611f\u67d3\u8005\u6216\u8005\u611f\u67d3\u72b6\u6001\u4e0d\u660e\u8005\u53d1\u751f\u660e\u786e\u7684\u4f53\u6db2\u4ea4\u6362\u884c\u4e3a\uff0c\u5c3d\u65e9\uff08\u4e0d\u8d85\u8fc772 h\uff09\u670d\u7528\u7279\u5b9a\u7684\u6297HIV\u836f\u7269\uff0c\u964d\u4f4eHIV\u611f\u67d3\u98ce\u9669\u7684\u751f\u7269\u5b66\u65b9\u6cd5\u3002<\/p>\n<p>HIV\u66b4\u9732\u5206\u4e3a\u804c\u4e1a\u66b4\u9732\u548c\u975e\u804c\u4e1a\u66b4\u9732\u3002<\/p>\n<p>12.1\u3000\u804c\u4e1a\u66b4\u9732\u3000HIV\u804c\u4e1a\u66b4\u9732\u662f\u6307\u536b\u751f\u4fdd\u5065\u4eba\u5458\u6216\u4eba\u6c11\u8b66\u5bdf\u6216\u5176\u4ed6\u4eba\u5458\u5728\u804c\u4e1a\u5de5\u4f5c\u4e2d\u4e0eHIV\u611f\u67d3\u8005\u7684\u8840\u6db2\u3001\u7ec4\u7ec7\u6216\u5176\u4ed6\u4f53\u6db2\u7b49\u63a5\u89e6\u800c\u5177\u6709\u611f\u67d3HIV\u7684\u5371\u9669\u3002<\/p>\n<p>12.1.1\u3000\u66b4\u9732\u9014\u5f84\u53ca\u5176\u5371\u9669\u5ea6\u3000\u53d1\u751f\u804c\u4e1a\u66b4\u9732\u7684\u9014\u5f84\u5305\u62ec\uff1a\u66b4\u9732\u6e90\u635f\u4f24\u76ae\u80a4\uff08\u523a\u4f24\u6216\u5272\u4f24\u7b49\uff09\u548c\u66b4\u9732\u6e90\u6cbe\u67d3\u4e0d\u5b8c\u6574\u76ae\u80a4\u6216\u9ecf\u819c\u3002\u5982\u66b4\u9732\u6e90\u4e3aHIV\u611f\u67d3\u8005\u7684\u8840\u6db2\uff0c\u90a3\u4e48\u7ecf\u76ae\u80a4\u635f\u4f24\u66b4\u9732\u611f\u67d3HIV\u7684\u5371\u9669\u6027\u4e3a0.3%\uff0c\u7ecf\u9ecf\u819c\u66b4\u9732\u4e3a0.09%\uff0c\u7ecf\u4e0d\u5b8c\u6574\u76ae\u80a4\u66b4\u9732\u7684\u5371\u9669\u5ea6\u5c1a\u4e0d\u660e\u786e\uff0c\u4e00\u822c\u8ba4\u4e3a&lt;0.1%\u3002<\/p>\n<p>\u66b4\u9732\u6e90\u5371\u9669\u5ea6\u7684\u5206\u7ea7\uff1a\u2460\u4f4e\u4f20\u67d3\u6027\uff1a\u75c5\u6bd2\u8f7d\u91cf\u6c34\u5e73\u4f4e\u3001\u66b4\u9732\u6e90\u63a5\u53d7ART\u5e76\u6709\u6301\u7eed\u75c5\u6bd2\u5b66\u6210\u529f\uff1b\u2461\u9ad8\u4f20\u67d3\u6027\uff1a\u75c5\u6bd2\u8f7d\u91cf\u9ad8\u3001AIDS\u665a\u671f\u3001\u672a\u63a5\u53d7ART\u6216\u4e0d\u89c4\u5f8b\u670d\u836f\u8005\uff1b\u2462\u66b4\u9732\u6e90\u60c5\u51b5\u4e0d\u660e\uff1a\u66b4\u9732\u6e90\u6240\u5904\u7684\u75c5\u7a0b\u9636\u6bb5\u4e0d\u660e\u3001\u66b4\u9732\u6e90\u662f\u5426\u4e3aHIV\u611f\u67d3\uff0c\u4ee5\u53ca\u6c61\u67d3\u7684\u5668\u68b0\u6216\u7269\u54c1\u6240\u5e26\u7684\u75c5\u6bd2\u8f7d\u91cf\u4e0d\u660e\u3002<\/p>\n<p>12.1.2\u3000HIV\u804c\u4e1a\u66b4\u9732\u540e\u5904\u7406\u539f\u5219\u3000\u2460\u7528\u80a5\u7682\u6db2\u548c\u6d41\u52a8\u7684\u6e05\u6c34\u6e05\u6d17\u88ab\u6c61\u67d3\u5c40\u90e8\uff1b\u2461\u6c61\u67d3\u773c\u90e8\u7b49\u9ecf\u819c\u65f6\uff0c\u5e94\u7528\u5927\u91cf\u7b49\u6e17\u6c2f\u5316\u94a0\u6eb6\u6db2\u53cd\u590d\u5bf9\u9ecf\u819c\u8fdb\u884c\u51b2\u6d17\uff1b\u2462\u5b58\u5728\u4f24\u53e3\u65f6\uff0c\u5e94\u8f7b\u67d4\u7531\u8fd1\u5fc3\u7aef\u5411\u8fdc\u5fc3\u7aef\u6324\u538b\u4f24\u5904\uff0c\u5c3d\u53ef\u80fd\u6324\u51fa\u635f\u4f24\u5904\u7684\u8840\u6db2\uff0c\u518d\u7528\u80a5\u7682\u6db2\u548c\u6d41\u52a8\u7684\u6e05\u6c34\u51b2\u6d17\u4f24\u53e3\uff1b\u2463\u752875%\u7684\u9152\u7cbe\u62160.5%\u7898\u4f0f\u5bf9\u4f24\u53e3\u5c40\u90e8\u8fdb\u884c\u6d88\u6bd2\u3002<\/p>\n<p>12.1.3\u3000HIV\u804c\u4e1a\u66b4\u9732\u540e\u9884\u9632\u6027\u7528\u836f\u539f\u5219\u3000\u2460\u963b\u65ad\u65b9\u6848\u3002\u9996\u9009\u63a8\u8350\u65b9\u6848\u4e3a\uff1aTDF\/FTC+RAL\uff08\u6216DTG\uff09\uff1b\u4e5f\u53ef\u8003\u8651\u9009\u62e9BIC\/FTC\/TAF\u3002\u5982\u679cINSTIs\u4e0d\u53ef\u53ca\uff0c\u6839\u636e\u5f53\u5730\u8d44\u6e90\uff0c\u53ef\u4ee5\u4f7f\u7528PIs\u5982LPV\/r\u548cDRV\/c\uff1b\u5bf9\u5408\u5e76\u80be\u529f\u80fd\u4e0b\u964d\u5e76\u6392\u9664\u6709HBV\u611f\u67d3\u7684\u53ef\u4ee5\u4f7f\u7528AZT\/3TC\u3002\u56fd\u5185\u6709\u7814\u7a76\uff3b52\uff3d\u663e\u793a\u542bABT\u7684PEP\u65b9\u6848\uff08ABT+DTG\uff0c\u6216ABT+TDF+3TC\uff09\u5177\u6709\u8f83\u9ad8\u7684\u6cbb\u7597\u5b8c\u6210\u7387\u548c\u4f9d\u4ece\u6027\u4ee5\u53ca\u5f88\u597d\u7684\u5b89\u5168\u6027\uff0c\u4f46\u8fd9\u65b9\u9762\u5c1a\u9700\u79ef\u7d2f\u66f4\u591a\u7684\u7814\u7a76\u8bc1\u636e\u3002\u2461\u5f00\u59cb\u6cbb\u7597\u7528\u836f\u7684\u65f6\u95f4\u53ca\u7597\u7a0b\u3002\u5728\u53d1\u751fHIV\u66b4\u9732\u540e\u5c3d\u53ef\u80fd\u5728\u6700\u77ed\u7684\u65f6\u95f4\u5185\uff08\u5c3d\u53ef\u80fd\u57282 h\u5185\uff09\u8fdb\u884c\u9884\u9632\u6027\u7528\u836f\uff0c\u6700\u597d\u572824 h\u5185\uff0c\u4f46\u4e0d\u8d85\u8fc772 h\uff0c\u8fde\u7eed\u670d\u752828 d\u3002<\/p>\n<p>12.1.4\u3000HIV\u804c\u4e1a\u66b4\u9732\u540e\u7684\u76d1\u6d4b\u3000\u53d1\u751fHIV\u804c\u4e1a\u66b4\u9732\u540e\u7acb\u5373\u30014\u5468\u30018\u5468\u300112\u5468\u548c24\u5468\u540e\u68c0\u6d4bHIV\u6297\u4f53\u3002\u5bf9\u5408\u5e76HBV\u611f\u67d3\u7684\u66b4\u9732\u8005\uff0c\u6ce8\u610f\u505c\u836f\u540e\u5bf9HBV\u76f8\u5173\u6307\u6807\u8fdb\u884c\u76d1\u6d4b\u3002<\/p>\n<p>12.1.5 \u9884\u9632\u804c\u4e1a\u66b4\u9732\u7684\u63aa\u65bd \u4e3b\u8981\u662f\u89c4\u8303\u64cd\u4f5c\uff0c\u505a\u597d\u6807\u51c6\u9884\u9632\u3002<\/p>\n<p>12.2\u3000\u975eHIV\u804c\u4e1a\u66b4\u9732\u3000\u6307\u9664\u804c\u4e1a\u66b4\u9732\u5916\u5176\u4ed6\u4e2a\u4eba\u884c\u4e3a\u53d1\u751f\u7684HIV\u66b4\u9732\u3002\u66b4\u9732\u8bc4\u4f30\u53ca\u5904\u7406\u539f\u5219\u5c24\u5176\u662f\u963b\u65ad\u7528\u836f\u4e0e\u804c\u4e1a\u66b4\u9732\u76f8\u540c\u3002\u5c24\u5176\u6ce8\u610f\u8bc4\u4f30\u540e\u963b\u65ad\u7528\u836f\u662f\u81ea\u613f\u7684\u539f\u5219\u53ca\u89c4\u8303\u968f\u8bbf\uff0c\u4ee5\u5c3d\u65e9\u53d1\u73b0\u611f\u67d3\u8005\u3002<\/p>\n<p>12.3\u3000\u6ce8\u610f\u4e8b\u9879\u3000\uff081\uff09\u4efb\u4f55\u963b\u65ad\u90fd\u662f\u5728\u5f53\u4e8b\u4eba\u81ea\u613f\u7684\u524d\u63d0\u4e0b\u5f00\u5c55\u548c\u5b9e\u65bd\uff0c\u5e76\u7b7e\u7f72\u77e5\u60c5\u540c\u610f\u4e66\uff0c\u5f3a\u8c03\u89c4\u8303\u968f\u8bbf\u3002\uff082\uff09\u5173\u6ce8\u963b\u65ad\u524d\u7684HBV\u611f\u67d3\u72b6\u6001\u3001\u809d\u80be\u529f\u80fd\u548c\u8840\u5e38\u89c4\u7684\u57fa\u7ebf\u68c0\u6d4b\u3002<\/p>\n<p>12.4\u3000\u66b4\u9732\u524d\u9884\u9632\uff08PrEP\uff09\u3000PrEP\u7684\u5b9a\u4e49\u4e3a\uff1a\u5f53\u4eba\u9762\u4e34HIV\u611f\u67d3\u9ad8\u98ce\u9669\u65f6\uff0c\u901a\u8fc7\u670d\u7528\u836f\u7269\u4ee5\u964d\u4f4e\u88ab\u611f\u67d3\u6982\u7387\u7684\u751f\u7269\u5b66\u9884\u9632\u65b9\u6cd5\u3002<\/p>\n<p>12.4.1\u3000\u9002\u5408\u4eba\u7fa4\u3000\u7537\u7537\u6027\u884c\u4e3a\u8005\uff08MSM\uff09\u3001\u4e0e\u7537\u5973\u53d1\u751f\u6027\u5173\u7cfb\u7684\u7537\u6027\u548c\u4e0d\u4f7f\u7528\u5b89\u5168\u5957\u7684\u7537\u6027\u3001\u53d8\u6027\u4eba\u3001\u6027\u5de5\u4f5c\u8005\u3001\u591a\u6027\u4f34\u8005\u3001STI\u60a3\u8005\u3001\u5171\u7528\u9488\u5177\u6216\u6ce8\u5c04\u5668\u6216\u5176\u4ed6\u5668\u5177\u8005\u3002<\/p>\n<p>12.4.2\u3000\u7528\u836f\u539f\u5219\u3000\u2460\u6bcf\u65e5\u670d\u836f\uff1a\u6bcf\u65e5\u670d\u7528TDF\/FTC\u662f\u5bf9\u6240\u6709\u9ad8\u98ce\u9669\u4eba\u7fa4\u63a8\u8350\u7684\u53e3\u670dPrEP\u65b9\u6848\uff0c\u63a8\u8350\u6bcf24 h\u53e3\u670d1\u7247TDF\/FTC\u3002\u5982\u6709\u8ba1\u5212\u505c\u6b62\u6216\u4e2d\u65adPrEP\uff0c\u9700\u5728\u6700\u540e\u4e00\u6b21\u98ce\u9669\u66b4\u9732\u540e\u6301\u7eed\u4f7f\u7528TDF\/FTC 7 d\u3002\u2461\u6309\u9700\u670d\u836f\uff082-1-1\u65b9\u6848\uff09\uff1a\u4ec5\u63a8\u8350\u7528\u4e8eMSM\uff0c2-1-1\u65b9\u6848\u5728\u9884\u671f\u6027\u884c\u4e3a\u53d1\u751f\u524d2~24 h\u53e3\u670d2\u7247TDF\/FTC\uff0c\u5728\u6027\u884c\u4e3a\u540e\uff0c\u8ddd\u4e0a\u6b21\u670d\u836f24 h\u670d\u836f1\u7247\uff0c48 h\u518d\u670d\u75281\u7247\u3002<\/p>\n<p>12.4.3\u3000\u968f\u8bbf\u548c\u76d1\u6d4b\u3000PrEP\u540e1\u4e2a\u6708\uff0c\u5e94\u968f\u8bbf\u5e76\u8fdb\u884cHIV\u6297\u539f\u6297\u4f53\u68c0\u6d4b\uff0c\u5176\u540e\u6bcf3\u4e2a\u6708\u968f\u8bbf\u4e00\u6b21\uff0c\u5e76\u5173\u6ce8\u80be\u529f\u80fd\u53d8\u5316\uff0c\u5efa\u8bae\u6bcf\u6b21\u968f\u8bbf\u8fdb\u884cHBV\u611f\u67d3\u6307\u6807\u548c\u6885\u6bd2\u8840\u6e05\u5b66\u68c0\u6d4b\u3002\u6bcf\u5e74\u68c0\u6d4b\u4e00\u6b21HCV\u6297\u4f53\u3002<\/p>\n<p>12.4.4\u3000\u6ce8\u610f\u4e8b\u9879\u3000\u5fc5\u987b\u8fdb\u884c\u57fa\u7ebf\u68c0\u67e5\u3001\u89c4\u8303\u968f\u8bbf\u548c\u884c\u4e3a\u8bc4\u4f30\u3002<\/p>\n<p>13\u3000HIV\u611f\u67d3\u7684\u5168\u7a0b\u7ba1\u7406<\/p>\n<p>ART\u7684\u51fa\u73b0\u548c\u5e94\u7528\u4f7f\u827e\u6ecb\u75c5\u76f8\u5173\u673a\u4f1a\u6027\u611f\u67d3\u548c\u80bf\u7624\u5927\u5927\u51cf\u5c11\uff0c\u5c06\u827e\u6ecb\u75c5\u53d8\u4e3a\u4e00\u79cd\u53ef\u4ee5\u6cbb\u7597\u4f46\u76ee\u524d\u5c1a\u96be\u4ee5\u5f7b\u5e95\u6cbb\u6108\u7684\u6162\u6027\u75be\u75c5\uff0c\u968f\u7740HIV\/AIDS\u60a3\u8005\u751f\u5b58\u671f\u7684\u5ef6\u957f\uff0c\u5404\u79cd\u975e\u827e\u6ecb\u75c5\u5b9a\u4e49\u6027\u75be\u75c5\uff08non-AIDS-defining 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