{"id":4056,"date":"2024-11-01T10:31:36","date_gmt":"2024-11-01T02:31:36","guid":{"rendered":"http:\/\/baijianyy.cn\/?p=4056"},"modified":"2024-11-01T10:31:54","modified_gmt":"2024-11-01T02:31:54","slug":"%e5%a4%a7%e5%ba%86%e5%b8%82-%e8%90%a8%e5%b0%94%e5%9b%be%e5%8c%ba-%e9%98%bb%e6%96%ad%e8%8d%af%e6%95%88%e6%9e%9c%e6%80%8e%e4%b9%88%e6%a0%b7-%e4%b8%ad%e5%9b%bdhiv%e6%9a%b4%e9%9c%b2%e5%89%8d%e9%a2%84","status":"publish","type":"post","link":"http:\/\/baijianyy.cn\/?p=4056","title":{"rendered":"\u5927\u5e86\u5e02 \u8428\u5c14\u56fe\u533a \u963b\u65ad\u836f\u6548\u679c\u600e\u4e48\u6837 \u4e2d\u56fdHIV\u66b4\u9732\u524d\u9884\u9632\u7528\u836f\u4e13\u5bb6\u5171\u8bc6"},"content":{"rendered":"

\u827e\u6ecb\u75c5\u963b\u65ad\u836f\u54ea\u91cc\u8d2d\u4e70\uff0c\u827e\u6ecb\u75c5\u963b\u65ad\u836f\u4ef7\u683c\uff0c\u827e\u6ecb\u75c5\u963b\u65ad\u836f\u54c1\u9500\u552e\u673a\u6784\uff1f
\npep\u963b\u65ad\u836f\u3001prep\u963b\u65ad\u836f\u5168\u56fd\u4e24\u5c0f\u65f6\u6025\u9001\uff0c\u836f\u5e97\u76f4\u53d1\uff0c\u4e13\u4eba\u4e13\u9001
\n\u827e\u6ecb\u75c5HIV\u66b4\u9732\u524d\u540e\u963b\u65ad\u9884\u9632\u7528\u836f\uff0c\u8bf7\u626b\u7801\u6dfb\u52a0\u533b\u9662\u5ba2\u670d\uff0c\u5168\u56fd\u5404\u57ce\u5e02\u6700\u5feb2\u5c0f\u65f6\u5de6\u53f3\u9001\u8fbe\u3002
\n\u9ad8\u5371\u884c\u4e3a\u540e\u591a\u4e45\u68c0\u6d4b\uff1f\u9ad8\u5371\u6027\u884c\u4e3a\u4e00\u6b21\u8981\u5403\u963b\u65ad\u836f\u5417\uff1f\u53d1\u751f\u9ad8\u5371\u6027\u884c\u4e3a\u540e\u600e\u4e48\u529e\uff1f\u9ad8\u5371\u884c\u4e3a\u591a\u5c11\u5929\u540e\u53ef\u4ee5\u5f7b\u5e95\u6392\u9664\uff1f\u7b49\u7b49\u95ee\u9898\uff0c\u53ef\u4ee5\u5728\u4e92\u8054\u7f51\u533b\u9662\u514d\u8d39\u54a8\u8be2\u4e13\u4e1a\u611f\u67d3\u79d1\u533b\u5e08\u3002<\/p>\n

\"\"\u963b\u65ad\u836f\u6548\u679c\u600e\u4e48\u6837\u00a0 \u6b64\u95ee\u9898\u8bf7\u626b\u4e0a\u9762\u7684\u4e8c\u7ef4\u7801\u5173\u6ce8\u4e92\u8054\u7f51\u533b\u9662\uff0c\u4e3a\u60a8\u89e3\u7b54\uff01<\/p>\n

\u81ea\u613f\u54a8\u8be2\u68c0\u6d4b\u673a\u6784\uff1a\u5927\u5e86\u5e02\u8428\u5c14\u56fe\u533a\u75be\u75c5\u9884\u9632\u63a7\u5236\u4e2d\u5fc3<\/p>\n

\u5730\u5740\uff1a\u8428\u5c14\u56fe\u533a\u4e1c\u98ce\u65b0\u6751\u7eac\u5341\u4e00\u8def\u5341\u53f7\uff08\u7231\u5fc3\u533b\u9662\uff09<\/p>\n

\n
<\/section>\n
1\u524d\u8a00<\/strong><\/section>\n
<\/section>\n<\/section>\n
\u00a0 \u00a0 \u827e\u6ecb\u75c5\u662f\u76ee\u524d\u4e16\u754c\u4e0a\u6700\u91cd\u5927\u7684\u516c\u5171\u536b\u751f\u6311\u6218\u4e4b\u4e00\u3002\u8981\u60f3\u5b9e\u73b02025\u5e74\u5168\u7403\u9632\u6cbb\u827e\u6ecb\u75c5\u76ee\u6807\uff0c\u5c06\u6bcf\u5e74\u65b0\u53d1\u611f\u67d3\u4eba\u6570\u63a7\u5236\u572837\u4e07\u4ee5\u4e0b\uff0c\u786e\u4fdd95%\u5b58\u5728HIV\u611f\u67d3\u98ce\u9669\u7684\u4eba\u7fa4\u83b7\u5f97\u9002\u5b9c\u3001\u6709\u6548\u7684\u9884\u9632\u670d\u52a1\uff0c\u5c31\u9700\u8981\u63d0\u4f9b\u66f4\u591a\u9884\u9632\u670d\u52a1\u7684\u9009\u62e9\uff0c\u5176\u4e2dPrEP<\/a>\u662fHIV\u7efc\u5408\u9884\u9632\u65b9\u6848\u7684\u5173\u952e\u7ec4\u6210\u90e8\u5206\u3002PrEP\u662f\u6307HIV\u9634\u6027\u4eba\u7fa4\u901a\u8fc7\u4f7f\u7528\u6297\u53cd\u8f6c\u5f55\u75c5\u6bd2\u836f\u7269\u6765\u9884\u9632HIV\u611f\u67d3\u7684\u751f\u7269\u5b66\u9884\u9632\u65b9\u6cd5\u3002PrEP\u5df2\u7ecf\u88ab\u8bc1\u660e\u53ef\u4ee5\u964d\u4f4e\u9ad8\u5371\u4eba\u7fa4\u611f\u67d3HIV\u7684\u98ce\u9669\uff3b2-3\uff3d\u3002<\/section>\n
<\/section>\n
\n
<\/section>\n
2\u00a0PrEP\u542f\u52a8\u524d\u51c6\u5907<\/strong><\/section>\n
<\/section>\n<\/section>\n
2.1\u3000\u9002\u5408\u4eba\u7fa4<\/strong>\u3000HIV\u7684\u611f\u67d3\u98ce\u9669\u5b58\u5728\u4eba\u7fa4\u548c\u5730\u533a\u5dee\u5f02\uff0c\u4eba\u7fa4\u548c\u5730\u533a\u662f\u5f71\u54cd\u4e2a\u4ebaHIV\u611f\u67d3\u98ce\u9669\u7684\u91cd\u8981\u56e0\u7d20\u3002\u7136\u800c\u5728\u5224\u65ad\u54ea\u4e9b\u4eba\u7fa4\u9002\u5408PrEP\u65f6\uff0c\u91cd\u8981\u8003\u8651\u7684\u662f\u4e2a\u4eba\u53ca\u5176\u4f34\u4fa3\u7684\u7279\u70b9\u548c\u884c\u4e3a\u3002\u5373\u4f7f\u67d0\u4e9b\u5730\u533aHIV\u603b\u4f53\u611f\u67d3\u7387\u8f83\u4f4e\uff0c\u4e5f\u53ef\u80fd\u6709\u4e00\u4e9b\u4eba\u5b58\u5728\u8f83\u9ad8\u611f\u67d3\u98ce\u9669\uff0c\u4f9d\u7136\u6709\u5fc5\u8981\u4e3a\u8fd9\u4e9b\u4eba\u63d0\u4f9bPrEP\u670d\u52a1\u3002\u4ee5\u6211\u56fd\u4e3a\u4f8b\uff0c\u867d\u7136\u65b0\u53d1\u4eba\u6570\u5448\u4e0b\u964d\u8d8b\u52bf\uff0c\u4f46\u5b58\u6d3b\u4eba\u6570\u8d8a\u6765\u8d8a\u591a\uff0c\u665a\u53d1\u73b0\u6bd4\u4f8b\u8f83\u9ad8\uff0c\u9ad8\u5371\u884c\u4e3a\u4eba\u7fa4\u5371\u9669\u56e0\u7d20\u4ecd\u7136\u5b58\u5728\uff0c\u5e72\u9884\u529b\u5ea6\u4ecd\u9700\u8981\u52a0\u5f3a\u3002\u800c\u56fd\u9645\u4e0a\u591a\u6570\u56fd\u5bb6\u7684HIV\u65b0\u53d1\u611f\u67d3\u591a\u89c1\u4e8e\u9752\u5e74\u4eba\u7fa4\uff3b<\/sup>4<\/sup>\uff3d<\/sup>\u3002\u56e0\u5730\u5236\u5b9c\u5730\u786e\u5b9aPrEP\u7684\u76ee\u6807\u4eba\u7fa4\uff0c\u5728\u5b9e\u8df5\u5de5\u4f5c\u4e2d\u5c24\u4e3a\u91cd\u8981\u3002\u6839\u636eWHO\u7684\u5b9a\u4e49\uff0cPrEP\u9002\u5408\u4eba\u7fa4\u662f\u6307\u90a3\u4e9b\u65e0\u8bba\u5f53\u5730HIV\u6d41\u884c\u60c5\u51b5\u5982\u4f55\uff0c\u7531\u4e8e\u7279\u5b9a\u7684\u9ad8\u98ce\u9669\u884c\u4e3a\u800c\u9762\u4e34HIV\u611f\u67d3\u7684\u7fa4\u4f53\uff3b<\/sup>3<\/sup>\uff3d<\/sup>\u3002\u9002\u5408\u4eba\u7fa4\u5305\u62ec\u4f46\u4e0d\u9650\u4e8e\uff1a1\uff09MSM\uff1b2\uff09\u6ce8\u5c04\u6bd2\u54c1\u3001\u836f\u7269\u6210\u763e\u8005\uff1b3\uff09\u6027\u5de5\u4f5c\u8005\uff1b4\uff09\u6027\u6d3b\u8dc3\u4eba\u7fa4\uff08\u9752\u58ee\u5e74\u53ca\u9752\u5c11\u5e74\uff09\uff1b5\uff09\u5355\u9633\u4f34\u4fa3\u4e2d\u7684HIV\u9634\u6027\u65b9\uff1b6\uff09\u8fd1\u671f\u611f\u67d3\u4e86\u6027\u4f20\u64ad\u75be\u75c5\u7684\u4eba\u7fa4\u3002<\/p>\n

\u9700\u8981\u5f3a\u8c03\u7684\u662f\uff0c\u5e76\u975e\u6240\u6709HIV\u9634\u6027\u8005\u90fd\u9002\u5408\u4f7f\u7528PrEP\u9884\u9632HIV\u611f\u67d3\uff0c\u53ea\u6709\u90a3\u4e9b\u5904\u4e8eHIV\u9ad8\u66b4\u9732\u98ce\u9669\u7684\u4eba\u5458\u624d\u9002\u5408\u4f7f\u7528PrEP\u3002\u5728\u5f00\u59cbPrEP\u4e4b\u524d\u9700\u8981\u5bf9\u5373\u5c06\u670d\u836f\u8005\u8fdb\u884cHIV\u66b4\u9732\u98ce\u9669\u8bc4\u4f30\u548c\u533b\u5b66\u8bc4\u4f30\u3002<\/p>\n

2.2\u3000\u98ce\u9669\u8bc4\u4f30<\/strong>\u3000\u63a8\u8350\u6240\u6709\u6027\u884c\u4e3a\u6d3b\u8dc3\u7684\u6210\u4eba\u53ca\u9752\u5c11\u5e74\u5747\u5e94\u77e5\u6653PrEP\u80fd\u591f\u6709\u6548\u9884\u9632HIV\u611f\u67d3\u7684\u76f8\u5173\u77e5\u8bc6\uff0c\u56e0\u4e3a\u5728\u4e86\u89e3\u76f8\u5173\u77e5\u8bc6\u540e\u4ed6\u4eec\u65e2\u80fd\u516c\u5f00\u56de\u7b54\u98ce\u9669\u8bc4\u4f30\u95ee\u9898\uff0c\u53c8\u80fd\u63d0\u9ad8\u5728\u793e\u4ea4\u7f51\u7edc\u548c\u53ef\u80fd\u53d7\u76ca\u7684\u5bb6\u5ead\u6210\u5458\u8ba8\u8bbaPrEP\u76f8\u5173\u95ee\u9898\u7684\u53ef\u80fd\u6027\u3002\u7814\u7a76\u8868\u660e\uff0c\u6c42\u8be2\u8005\u901a\u5e38\u4e0d\u4f1a\u4e3b\u52a8\u66b4\u9732\u5176\u9690\u79c1\u884c\u4e3a\uff0c\u5982\u6027\u884c\u4e3a\u6216\u8fdd\u7981\u836f\u7269\u4f7f\u7528\u60c5\u51b5\uff08\u5c24\u5176\u662f\u5728\u6ca1\u6709\u88ab\u95ee\u53ca\u5177\u4f53\u884c\u4e3a\u65f6\uff09\uff3b<\/sup>5<\/sup>\uff3d<\/sup>\u3002\u56e0\u6b64\uff0c\u95ee\u8bca\u662f\u4e86\u89e3HIV\u611f\u67d3\u98ce\u9669\u884c\u4e3a\u7684\u4e3b\u8981\u65b9\u6cd5\uff0c\u672c\u5171\u8bc6\u501f\u9274\u4e86\u56fd\u9645\u6307\u5357\u5217\u4e3e\u7684\u95ee\u9898\u6765\u8f85\u52a9\u4e13\u4e1a\u4eba\u5458\u66f4\u52a0\u51c6\u786e\u5730\u8bc4\u4f30\u670d\u52a1\u5bf9\u8c61\u7684HIV\u611f\u67d3\u9ad8\u5371\u884c\u4e3a\u98ce\u9669\uff3b<\/sup>6<\/sup>\uff3d<\/sup>\u3002\u8fd9\u4e9b\u95ee\u9898\u5305\u62ec\uff1a<\/p>\n

\u5728\u8fc7\u53bb6\u4e2a\u6708\u4e2d\uff1a<\/p>\n

1\uff09 \u4f60\u662f\u5426\u53d1\u751f\u8fc7\u65e0\u5b89\u5168\u5957\u7684\u7537\u7537\u540c\u6027\u6027\u884c\u4e3a\u6216\u5f02\u6027\u6027\u884c\u4e3a\uff1f<\/p>\n

2\uff09 \u4f60\u662f\u5426\u6ce8\u5c04\u8fc7\u8fdd\u7981\u836f\u7269\u5e76\u4e14\u6709\u8fc7\u5171\u7528\u9488\u5177\u5438\u6bd2\u7684\u60c5\u51b5\uff1f<\/p>\n

3\uff09 \u5728\u4f60\u7684\u6027\u4f34\u4e2d\uff0c\u662f\u5426\u6709HIV\u611f\u67d3\u8005\uff1f<\/p>\n

4\uff09 \u4f60\u662f\u5426\u88ab\u65b0\u8bca\u65ad\u60a3\u6709\u6027\u4f20\u64ad\u75be\u75c5\uff0c\u5982\u6885\u6bd2\uff0c\u6dcb\u75c5\u548c\u8863\u539f\u4f53\u611f\u67d3\uff1f<\/p>\n

\u4e0a\u8ff0\u95ee\u9898\u4e2d\u6027\u884c\u4e3a\u53ef\u4ee5\u662f\u809b\u4ea4\u548c\u9634\u9053\u6027\u4ea4\uff0c\u53ea\u8981\u6709\u4e00\u4e2a\u95ee\u9898\u7b54\u6848\u4e3a\u201c\u662f\u201d\u4fbf\u53ef\u89c6\u4e3a\u201cHIV\u9ad8\u66b4\u9732\u98ce\u9669\u884c\u4e3a\u201d\u3002\u5982\u679c\u5176HIV\u9633\u6027\u6027\u4f34\u4fa3\u5df2\u7ecf\u5f00\u59cb\u6301\u7eed\u6297\u75c5\u6bd2\u6cbb\u7597\uff0c\u5e76\u4e14\u5728\u8fc7\u53bb6\u4e2a\u6708\u4e2d\u75c5\u6bd2\u8f7d\u91cf\u6301\u7eed\u88ab\u6291\u5236\uff08\u75c5\u6bd2\u8f7d\u91cf<200 copies\/mL\uff09\uff0c\u6216\u8005\u77e5\u6653\u6027\u4f34\u4fa3\u4e3a\u975eHIV\u611f\u67d3\u8005\uff0c\u5747\u53ef\u4ee5\u4e0d\u88ab\u5217\u4e3a\u201cHIV\u9ad8\u66b4\u9732\u98ce\u9669\u884c\u4e3a\u201d\u3002<\/p>\n

\u5bf9\u4e8e\u4e3b\u52a8\u8981\u6c42\u8fdb\u884cPrEP\u7684\u4eba\u7fa4\u4e5f\u5e94\u7ed9\u4e88PrEP\uff0c\u56e0\u4e3a\u8fd9\u79cd\u884c\u4e3a\u4ee3\u8868\u4e86\u5176\u66f4\u53ef\u80fd\u6709\u611f\u67d3HIV\u7684\u98ce\u9669\uff3b<\/sup>3,7<\/sup>\uff3d<\/sup>\u3002<\/p>\n

2.3\u3000\u533b\u5b66\u8bc4\u4f30<\/strong>\u3000\u786e\u8ba4\u662f\u9ad8\u98ce\u9669\u4eba\u7fa4\u540e\uff0c\u8fd8\u9700\u8981\u518d\u8fdb\u884c\u533b\u5b66\u8bc4\u4f30\u3002\u7b26\u5408\u4e0b\u5217\u6240\u6709\u6761\u4ef6\u7684\uff0c\u624d\u9002\u5b9c\u63a5\u53d7 PrEP\u3002<\/p>\n

1\uff09 \u6027\u6d3b\u8dc3\u9752\u5c11\u5e74\u6216\u6210\u4eba\uff1b<\/p>\n

2\uff09 HIV\u6297\u4f53\u68c0\u6d4b\u7ed3\u679c\u5448\u9634\u6027\uff1b<\/p>\n

3\uff09 \u5b58\u5728HIV\u9ad8\u66b4\u9732\u98ce\u9669\u884c\u4e3a\uff1b<\/p>\n

4\uff09 \u4e0d\u5b58\u5728HIV\u6025\u6027\u671f\u611f\u67d3\u53ef\u80fd\uff1b<\/p>\n

5\uff09 \u65e0\u4e0d\u9002\u5b9c\u4f7f\u7528PrEP\u836f\u7269\u7684\u60c5\u51b5\uff1b<\/p>\n

6\uff09 \u4fdd\u8bc1\u4f9d\u4ece\u6027\uff0c\u5b9a\u671f\u968f\u8bbf\u68c0\u6d4b\uff1b<\/p>\n

7\uff09 \u610f\u8bc6\u6e05\u9192\uff0c\u7cbe\u795e\u6b63\u5e38\uff0c\u80fd\u591f\u81ea\u4e3b\u51b3\u7b56\u3002<\/p>\n

\u7279\u522b\u5f3a\u8c03\uff0c\u5b9e\u65bdPrEP\u524d\u5fc5\u987b\u8fdb\u884cHIV\u68c0\u6d4b<\/a>\uff0c\u786e\u4fdd\u670d\u52a1\u5bf9\u8c61\u6ca1\u6709\u611f\u67d3HIV\u3002\u5bf9\u5df2\u7ecf\u611f\u67d3\u7684\u4f46\u5374\u4ece\u672a\u88ab\u8bca\u65ad\u51fa\u7684HIV\u9633\u6027\u8005\u8fdb\u884cPrEP\u53ef\u80fd\u4f1a\u5bfc\u81f4\u8010\u836f\u98ce\u9669\uff0c\u5e76\u5bf9\u5176\u540e\u7eed\u6cbb\u7597\u4ea7\u751f\u4e25\u91cd\u7684\u4e0d\u826f\u540e\u679c\u3002\u6b64\u5916\uff0c\u57fa\u7ebf\u5b9e\u9a8c\u5ba4\u68c0\u67e5\u8fd8\u9700\u6392\u9664\u4f7f\u7528PrEP\u836f\u7269\u7684\u7981\u5fcc\u8bc1\u548c\u76f8\u5173\u60c5\u51b5\u3002<\/p>\n

1\uff09 HIV\u68c0\u6d4b\uff1a\u53c2\u7167\u6211\u56fd\u300a\u5168\u56fd\u827e\u6ecb\u75c5\u68c0\u6d4b\u6280\u672f\u89c4\u8303\u300b\uff3b<\/sup>8<\/sup>\uff3d<\/sup>\uff0c\u8fdb\u884c\u6210\u4eba\u548c\u9752\u5c11\u5e74\uff08>14\u5c81\uff09HIV\u611f\u67d3\u7684\u8bca\u65ad\u3002\u5fc5\u8981\u65f6\u8840\u6db2\u7684HIV\u81ea\u6211\u68c0\u6d4b\u7ed3\u679c\u4e5f\u53ef\u4ee5\u4f5c\u4e3a\u542f\u52a8PrEP\u7684\u4f9d\u636e\uff0c\u4f46\u662f\u4ecd\u9700\u8981\u5728\u5f53\u5929\u8865\u5145\u8fdb\u884cHIV\u6297\u539f\/\u6297\u4f53\u68c0\u6d4b\u3002\u5982\u679c\u60a3\u80053\u4e2a\u6708\u5185\u66fe\u4f7f\u7528\u8fc7\u53e3\u670dPrEP\u836f\u7269\uff0c\u6216\u800512\u4e2a\u6708\u5185\u66fe\u4f7f\u7528\u808c\u6ce8\u957f\u6548PrEP\u836f\u7269\uff0c\u9700\u540c\u65f6\u8fdb\u884c\u6297\u539f\/\u6297\u4f53\u68c0\u6d4b\u548cHIV\u6838\u9178\u68c0\u6d4b\u3002\u533b\u52a1\u4eba\u5458\u5c24\u5176\u9700\u8981\u6ce8\u610f\u6392\u9664\u5904\u4e8eHIV\u6025\u6027\u671f\u611f\u67d3\u7684\u53ef\u80fd\uff08\u56fe1\uff09\u3002<\/p>\n

2\uff09 \u80be\u529f\u80fd\u68c0\u6d4b\uff1a\u4f7f\u7528\u53e3\u670dPrEP\u836f\u7269\u524d\u4e34\u5e8a\u533b\u751f\u5fc5\u987b\u8bc4\u4f30\u80be\u529f\u80fd\uff0c\u56e0\u4e3a\u4f7f\u7528TDF\/FTC\u6216TAF\/FTC\u53ef\u5bfc\u81f4\u80be\u529f\u80fd\u4e0b\u964d\uff0c\u8fd9\u662f\u4e00\u4e2a\u6f5c\u5728\u7684\u5b89\u5168\u95ee\u9898\u3002\u5efa\u8baeTDF\/FTC\u7528\u4e8eeGFR\u226560 mL\/min\u7684\u4eba\u7fa4\u4e2d\uff0cTAF\/FTC\u7528\u4e8eeGFR\u226530 mL\/min\u7684\u4eba\u7fa4\u4e2d\uff3b<\/sup>6<\/sup>\uff3d<\/sup>\u3002<\/p>\n

3\uff09 \u8840\u8102\u68c0\u6d4b\uff1a\u4f7f\u7528TAF\/FTC\u8fdb\u884cPrEP\u524d\u5e94\u8bc4\u4f30\u8840\u8102\u6c34\u5e73\uff0c\u56e0TAF\/FTC\u5b58\u5728\u5bfc\u81f4\u8840\u8102\u5347\u9ad8\u7684\u98ce\u9669\uff0c\u9700\u8981\u5bc6\u5207\u76d1\u6d4b\u8840\u8102\u53d8\u5316\u60c5\u51b5\uff0c\u5f53\u6709\u5f02\u5e38\u65f6\u5e94\u53ca\u65f6\u8fdb\u884c\u5e72\u9884\u3002<\/p>\n

4\uff09HBV\u8840\u6e05\u5b66\u68c0\u6d4b\uff1a\u6027\u6d3b\u8dc3\u4eba\u7fa4\uff08\u5c24\u5176\u662fMSM\uff09\u548c\u9759\u8109\u6ce8\u5c04\u5438\u6bd2\u8005\uff08intravenous drug users\uff0cIDUs\uff09\u901a\u5e38\u4e5f\u662fHBV\u548cHCV\u611f\u67d3\u7684\u9ad8\u5371\u4eba\u7fa4\u3002\u7531\u4e8ePrEP\u836f\u7269\u540c\u65f6\u5bf9HBV\u611f\u67d3\u4e5f\u6709\u6cbb\u7597\u4f5c\u7528\uff0c\u5bf9\u4e8e\u4e59\u578b\u809d\u708e\u8868\u9762\u6297\u539f\u9633\u6027\u8005\uff08HBsAg+\uff09\uff0c\u5728\u5f00\u5c55PrEP\u671f\u95f4\u5982\u679c\u53d1\u751f\u505c\u836f\uff0c\u5219\u4f1a\u6709HBV\u53cd\u5f39\u7684\u98ce\u9669\uff0c\u56e0\u6b64\u6cbb\u7597\u524d\u4e00\u5b9a\u8981\u68c0\u6d4b\u670d\u52a1\u5bf9\u8c61\u7684HBV\u611f\u67d3\u60c5\u51b5\u3002\u7136\u800c\uff0c\u5728\u7b49\u5f85HBV\u68c0\u6d4b\u7ed3\u679c\u7684\u540c\u65f6\uff0c\u4e0d\u5e94\u63a8\u8fdfPrEP\u7684\u542f\u52a8\u3002HBV\u611f\u67d3\u5e76\u4e0d\u662f\u5f00\u5c55PrEP\u7684\u7981\u5fcc\u8bc1\uff0c\u4f46\u662f\u533b\u751f\u9700\u8981\u505a\u597d\u533b\u7597\u8bc4\u4f30\u6216\u8005\u8bf7\u809d\u75c5\u4e13\u5bb6\u8fdb\u884c\u4f1a\u8bca\u3002<\/p>\n

5\uff09 \u6027\u4f20\u64ad\u75be\u75c5\uff1a\u8fd1\u534a\u5e74\u6709\u6027\u75c5\u611f\u67d3\u53f2\u662f\u4f18\u5148\u63a8\u8350PrEP\u9884\u9632\u7684\u6307\u5f81\u4e4b\u4e00\u3002\u5728\u6211\u56fd\uff0c\u63d0\u4f9bHIV\u68c0\u6d4b\u7684\u673a\u6784\u901a\u5e38\u4e5f\u4f1a\u63d0\u4f9b\u6885\u6bd2\u7b5b\u67e5\u3002\u5728\u591a\u6570\u5730\u533a\uff0cRPR\u662f\u5e38\u7528\u7684\u7b5b\u67e5\u65b9\u6cd5\uff0c\u5982\u679c\u9634\u6027\u53ef\u6392\u9664\u6885\u6bd2\u611f\u67d3\uff1b\u5982\u679c\u9633\u6027\uff0c\u5219\u9700\u8981\u8fdb\u884c\u6885\u6bd2\u87ba\u65cb\u4f53\u8840\u6e05\u5b66\u68c0\u6d4b\uff08\u5982\uff1aTPPA\uff09\u8fdb\u884c\u590d\u68c0\uff0c\u786e\u8ba4\u662f\u5426\u4e3a\u6885\u6bd2\u87ba\u65cb\u4f53\u611f\u67d3\u3002\u4e5f\u53ef\u4ee5\u5148\u8fdb\u884c\u6885\u6bd2\u87ba\u65cb\u4f53\u8840\u6e05\u5b66\u68c0\u6d4b\uff0c\u5982\u679c\u9634\u6027\uff0c\u6392\u9664\u611f\u67d3\uff1b\u5982\u679c\u9633\u6027\uff0c\u8fdb\u4e00\u6b65\u8fdb\u884cRPR\u68c0\u6d4b\u4ee5\u786e\u5b9a\u662f\u65e2\u5f80\u611f\u67d3\u8fd8\u662f\u73b0\u75c7\u611f\u67d3\uff0c\u4ee5\u4fbf\u6307\u5bfc\u6cbb\u7597\u3002\u5176\u4ed6\u6027\u4f20\u64ad\u75be\u75c5\u53ef\u4ee5\u6839\u636e\u4e0d\u540c\u5730\u533a\u9700\u6c42\u548c\u8d44\u6e90\u53ef\u53ca\u6027\uff0c\u63d0\u4f9b\u76f8\u5e94\u7684\u8bca\u7597\u3002<\/p>\n

6\uff09 \u598a\u5a20\u68c0\u6d4b\uff1a\u598a\u5a20\u672c\u8eab\u4e0d\u662f\u5f00\u5c55PrEP\u7684\u7981\u5fcc\u8bc1\uff0c\u4f46\u76ee\u524dTAF\/FTC\u548c\u5361\u66ff\u62c9\u97e6\uff08cabotegravir\uff0cCAB\uff09\u5728\u598a\u5a20\u671f\u5e94\u7528\u7684\u6570\u636e\u8f83\u5c11\u3002\u5728\u5f00\u5c55PrEP\u524d\u9700\u8981\u8bb0\u5f55\u5973\u6027\u53c2\u4e0e\u8005\u598a\u5a20\u68c0\u6d4b\u7ed3\u679c\uff0c\u5e76\u63d0\u4f9b\u76f8\u5e94\u54a8\u8be2\uff0c\u5305\u62ec\u907f\u5b55\u77e5\u8bc6\u548c\u4e00\u65e6\u6000\u5b55\u540e\u7684\u56f4\u751f\u671f\u4fdd\u5065\u77e5\u8bc6\u3002<\/p>\n

2.4\u3000\u5feb\u901f\u542f\u52a8PrEP<\/strong>\u3000\u7f29\u77ed\u5f00\u59cbPrEP\u7684\u65f6\u95f4\u53ef\u80fd\u5bf9\u4e00\u4e9b\u9002\u7528\u4eba\u7fa4\u66f4\u6709\u76ca\u3002\u4f8b\u5982\u90e8\u5206\u4eba\u7fa4\u65e0\u6cd5\u5728\u8bc4\u4f30\u540e\u4e00\u4e24\u5468\u5185\u590d\u8bca\u53d6\u836f\uff0c\u4f46\u4ed6\u4eec\u5728\u6b64\u671f\u95f4\u4ecd\u6709\u53ef\u80fd\u5b58\u5728HIV\u611f\u67d3\u7684\u9ad8\u98ce\u9669\u884c\u4e3a\u3002\u56e0\u6b64\uff0c\u4e00\u4e9b\u5730\u533a\u5236\u5b9a\u4e86\u5f53\u5929\u542f\u52a8PrEP\u65b9\u6848\uff0c\u5141\u8bb8\u4e34\u5e8a\u533b\u751f\u5728\u8fdb\u884c\u521d\u59cb\u8bc4\u4f30\u7684\u540c\u4e00\u5929\u5b89\u5168\u542f\u52a8PrEP\uff3b<\/sup>9-11<\/sup>\uff3d<\/sup>\u3002\u5feb\u901f\u5b89\u5168\u542f\u52a8PrEP\u9700\u8981\u786e\u5b9a\u670d\u52a1\u5bf9\u8c61\u662f\u5426\u611f\u67d3HIV\u548c\u8bc4\u4f30\u80be\u529f\u80fd\u3002<\/p>\n

\u8981\u5f53\u5929\u542f\u52a8PrEP\u65b9\u6848\uff0c\u9700\u8981\u6ee1\u8db3\u4ee5\u4e0b\u6761\u4ef6\uff1a<\/p>\n

1\uff09\u80fd\u591f\u8fdb\u884c\u5373\u65f6HIV\u68c0\u6d4b\uff0c\u6700\u597d\u91c7\u7528\u8840\u6db2\u68c0\u6d4b\u3002<\/p>\n

\u80fd\u591f\u5728\u5f53\u5929\u83b7\u5f97\u7ed3\u679c\u7684\u533b\u9662\uff0c\u53ef\u4ee5\u4f7f\u7528\u5b9e\u9a8c\u5ba4\u6297\u539f\u6297\u4f53\u68c0\u6d4b\u6216HIV \u6838\u9178\u68c0\u6d4b\uff08\u9996\u9009\uff09\u3002<\/p>\n

\u4e0d\u5efa\u8bae\u4f7f\u7528\u901a\u8fc7\u975e\u8840\u6db2\u68c0\u6d4b\u7684HIV\u5feb\u901f\u68c0\u6d4b\u624b\u6bb5\u3002<\/p>\n

2\uff09 \u5982\u679c\u5f53\u5929\u65e0\u6cd5\u83b7\u5f97HIV\u548c\u80be\u529f\u68c0\u6d4b\u7ed3\u679c\uff0c\u4e5f\u5e94\u62bd\u8840\u9001\u68c0\uff0c\u77e5\u6653\u6c42\u8be2\u8005HIV\u611f\u67d3\u72b6\u51b5\u6216\u80be\u529f\u662f\u5426\u5f02\u5e38\u662f\u63d0\u4f9b\u540e\u7eed\u670d\u52a1\u7684\u5173\u952e\u3002<\/p>\n

\u5f53\u5929\u542f\u52a8PrEP\u65b9\u6848\u4e0d\u9002\u5408\u7528\u4e8e\u4ee5\u4e0b\u60c5\u51b5\uff1a<\/p>\n

1\uff09 \u5bf9\u542f\u52a8PrEP\u8868\u73b0\u51fa\u77db\u76fe\u5fc3\u7406\uff08\u4f8b\u5982\uff1a\u9700\u8981\u66f4\u591a\u65f6\u95f4\u601d\u8003\uff09\uff1b<\/p>\n

2\uff09 \u65e0\u6cd5\u62bd\u8840\u8fdb\u884c\u5b9e\u9a8c\u5ba4\u68c0\u6d4b\uff1b<\/p>\n

3\uff09 \u6709\u8ff9\u8c61\/\u75c7\u72b6\u548c\u6d41\u884c\u75c5\u53f2\u8868\u660e\u53ef\u80fd\u4e3aHIV\u611f\u67d3\u6025\u6027\u671f\uff1b<\/p>\n

4\uff09 \u6709\u80be\u810f\u75be\u75c5\u53f2\u6216\u76f8\u5173\u75be\u75c5\uff08\u5982\u9ad8\u8840\u538b\u3001\u7cd6\u5c3f\u75c5\uff09\uff1b<\/p>\n

5\uff09\u4e0d\u80fd\u63d0\u4f9b\u51c6\u786e\u8054\u7cfb\u65b9\u5f0f\u7b49\u5bfc\u81f4\u540e\u7eed\u590d\u8bca\u56f0\u96be\u8005\u3002<\/p>\n

\n
<\/section>\n
3\u00a0PrEP\u7528\u836f\u65b9\u6848\u53ca\u7ba1\u7406<\/strong><\/section>\n
<\/section>\n<\/section>\n
\u00a0 \u00a0\u00a0\u5168\u7403\u5df2\u7ecf\u5f00\u5c55\u8fc7\u591a\u9879\u9488\u5bf9MSM\u6216\u8de8\u6027\u522b\u5973\u6027\uff08transgender women\uff0cTGW\uff09\u3001\u9ad8\u98ce\u9669\u5f02\u6027\u604b\u4eba\u7fa4\u4ee5\u53caIDUs\u7684PrEP\u4e34\u5e8a\u8bd5\u9a8c\u7814\u7a76\u548c\u771f\u5b9e\u4e16\u754c\u7814\u7a76\uff0c\u5df2\u5145\u5206\u8bc1\u660ePrEP\u53ef\u4ee5\u964d\u4f4e\u9ad8\u98ce\u9669\u4eba\u7fa4\u611f\u67d3HIV\u7684\u98ce\u9669\uff0c\u76ee\u524d\u56fd\u9645\u4e0a\u53ef\u9009\u62e9\u7684PrEP\u624b\u6bb5\u5305\u62ec\u53e3\u670d\u836f\u7269\u65b9\u6848\uff0c\u957f\u6548\u836f\u7269\u65b9\u6848\u548c\u8fbe\u5339\u97e6\u6797\u9634\u9053\u73af\u7684\u4f7f\u7528\u30023.1\u3000\u53e3\u670d\u65b9\u6848\u3000<\/strong><\/p>\n

3.1.1\u3000\u53e3\u670d\u836f\u7269\u9009\u62e9\u3000\u76ee\u524d\u56fd\u9645\u6307\u5357\u63a8\u8350\u7528\u4e8ePrEP\u7684\u53e3\u670d\u836f\u7269\u4e3b\u8981\u5305\u62ecTDF\/FTC\u548cTAF\/FTC\u3002TAF\/FTC\u5df2\u88ab\u7f8e\u56fd\u98df\u54c1\u836f\u54c1\u76d1\u7763\u7ba1\u7406\u5c40\uff08Food and drug administration\uff0cFDA\uff09\u6279\u51c6\u7528\u4e8e\u6210\u4eba\u548c\u9752\u5c11\u5e74\uff08\u4f53\u91cd\u81f3\u5c11\u572835 kg\u4ee5\u4e0a\uff09PrEP\u7684\u836f\u7269\uff0c\u4f46\u5176\u9002\u5e94\u8bc1\u4ec5\u9650\u7537\u6027\u53caTGW\uff0c\u4e0d\u5305\u62ec\u5973\u6027\u7b49\u56e0\u63a5\u53d7\u9634\u9053\u6027\u884c\u4e3a\u800c\u5b58\u5728HIV\u611f\u67d3\u98ce\u9669\u7684\u4e2a\u4f53\u3002<\/p>\n

TDF\/FTC\u4ecd\u7136\u662f\u76ee\u524dPrEP\u6700\u5e38\u7528\u7684\u65b9\u6848\uff0c\u5168\u7403\u5df2\u7ecf\u5f00\u5c55\u8fc7\u591a\u9879\u9488\u5bf9MSM\u6216TGW\u3001\u9ad8\u98ce\u9669\u5f02\u6027\u604b\u4eba\u7fa4\u4ee5\u53caIDUs\u7684PrEP\u4e34\u5e8a\u8bd5\u9a8c\u548c\u771f\u5b9e\u4e16\u754c\u7814\u7a76\uff0c\u76f8\u6bd4\u4e8e\u6ca1\u6709\u8fdb\u884cPrEP\u7684\u4eba\u7fa4\uff0cTDF\/FTC\u80fd\u591f\u964d\u4f4e45%~86%\u7684HIV\u611f\u67d3\u98ce\u9669\uff3b<\/sup>12-17<\/sup>\uff3d<\/sup>\u3002\u540c\u65f6\uff0c\u670d\u836f\u4f9d\u4ece\u6027\u5bf9\u4e8ePrEP\u6210\u529f\u7387\u548c\u51cf\u5c11\u8010\u836f\u81f3\u5173\u91cd\u8981\uff3b<\/sup>18-19<\/sup>\uff3d<\/sup>\u3002\u53e6\u5916\u4e5f\u6709\u7814\u7a76\u53d1\u73b0\uff0c\u7531\u4e8e\u5973\u6027\u9700\u8981\u6bcf\u5468\u670d\u7528PrEP\u836f\u72696~7\u7247\uff08\u670d\u836f\u4f9d\u4ece\u6027>85%\uff09\u624d\u80fd\u9884\u9632\u9634\u9053\u7ec4\u7ec7\u7684HIV\u611f\u67d3\uff0c\u56e0\u6b64\u6b64\u65b9\u6848\u5bf9\u4e8e\u5973\u6027\u6f0f\u670d\u836f\u7269\u7684\u5bbd\u5bb9\u5ea6\u66f4\u4f4e\uff3b<\/sup>20<\/sup>\uff3d<\/sup>\u3002<\/p>\n

TAF\/FTC\u7528\u4e8ePrEP\u7684\u6570\u636e\u4e3b\u8981\u6765\u81ea\u4e00\u9879\u968f\u673a\u53cc\u76f2\u5bf9\u7167\u975e\u52a3\u6548\u7684\u2162\u671f\u4e34\u5e8a\uff08DISCOVER\uff09\u7814\u7a76\uff0c\u7814\u7a76\u4eba\u7fa4\u4e3aMSM\u548cTGW\uff0c\u7ed3\u679c\u663e\u793a\u53e3\u670dTAF\/FTC\u7684PrEP\u9884\u9632HIV\u7684\u6548\u679c\u975e\u52a3\u4e8eTDF\/FTC\uff0c\u4e24\u7ec4\u7684HIV\u611f\u67d3\u7387\u5206\u522b\u4e3a0.16\/100\u4eba\u5e74\u548c0.34\/100\u4eba\u5e74\uff3b<\/sup>21<\/sup>\uff3d<\/sup>\u3002\u9664\u57fa\u7ebf\u5916\uff0c\u4e24\u7ec4HIV\u6297\u4f53\u8f6c\u9633\u7684\u53d7\u8bd5\u8005\u4e2d\u5747\u672a\u53d1\u73b0FTC\u6216TAF\u8010\u836f\u3002\u540c\u65f6\uff0cTAF\/FTC\u53e3\u670d\u6bd4TDF\/FTC\u53ef\u66f4\u5feb\u68c0\u6d4b\u5230\u7ec6\u80de\u5185\u836f\u7269\u6d53\u5ea6\u6c34\u5e73\uff0c\u4e14\u6301\u7eed\u65f6\u95f4\u66f4\u957f\uff3b<\/sup>21-23<\/sup>\uff3d<\/sup>\u3002\u56e0\u6b64\uff0cTAF\/FTC\u663e\u793a\u51fa\u5728PrEP\u9886\u57df\u7684\u5e94\u7528\u6f5c\u529b\u3002<\/p>\n

WHO\u8ba4\u4e3aFTC\u548c3TC\u65e0\u8bba\u5728\u6297HIV\u6cbb\u7597\u8fd8\u662f\u9884\u9632\u65b9\u9762\u90fd\u662f\u5f7c\u6b64\u53ef\u4ee5\u66ff\u4ee3\u7684\u836f\u7269\u3002\u4e0d\u8fc7\u9274\u4e8e\u9664\u4e86\u4e00\u9879\u2160\u671f\u9879\u76ee\u5916\uff0c\u5c1a\u7f3a\u4e4f\u57fa\u4e8e3TC\u5f00\u5c55PrEP\u5145\u5206\u4e34\u5e8a\u7814\u7a76\u6570\u636e\uff0c\u5f53\u524d\u4e2d\u56fd\u3001\u7f8e\u56fd\u548c\u6b27\u76df\u5747\u672a\u6279\u51c6\u57fa\u4e8e3TC\u5f00\u5c55PrEP\u7684\u836f\u7269\u9002\u5e94\u8bc1\u3002\u56e0\u6b64\uff0c\u4ec5\u5728FTC\u83b7\u5f97\u6709\u56f0\u96be\u7684\u60c5\u51b5\u4e0b\uff0c\u53ef\u4ee5\u8003\u8651\u4f7f\u75283TC\u66ff\u4ee3FTC\uff3b24<\/sup>\uff3d<\/sup>\u3002<\/p>\n

3.1.2\u3000\u670d\u836f\u65b9\u6848\u3000\u56fd\u9645\u4e0a\u53e3\u670d\u836f\u7269\u7528\u4e8ePrEP\u7684\u670d\u836f\u65b9\u5f0f\u4e3b\u8981\u6709\u4e24\u79cd\uff0c\u5206\u522b\u4e3a\u6bcf\u65e5\u670d\u836f\u65b9\u6848\u548c\u4e8b\u4ef6\u9a71\u52a8\u670d\u836f\u65b9\u6848\uff08event-driven\uff0cED-PrEP\uff09\uff3b\u53c8\u79f0\u6309\u9700\uff08on-demand\uff09\u670d\u836f\u65b9\u6848\uff3d\u3002<\/p>\n

1\uff09 \u6bcf\u65e5\u670d\u836f\u65b9\u6848\uff1a\u6bcf24 h\u53e3\u670d1\u7247\uff08TDF\/FTC\u6216TAF\/FTC\uff09\uff0c\u9700\u8fde\u7eed\u670d\u75287\u5929\u540e\u624d\u53ef\u8fdb\u884cHIV\u9ad8\u5371\u884c\u4e3a\uff0c\u672b\u6b21HIV\u9ad8\u5371\u884c\u4e3a\u7ed3\u675f\u540e\u9700\u8981\u7ee7\u7eed\u670d\u75287\u5929\u65b9\u53ef\u505c\u836f\u3002<\/p>\n

2\uff09 \u6309\u9700\u670d\u836f\u65b9\u6848\uff1a\u6307\u5728\u9884\u671f\u6027\u884c\u4e3a\u53d1\u751f\u524d2~24 h\u53e3\u670d2\u7247TDF\/FTC\uff0c\u5728\u6027\u884c\u4e3a\u540e\u8ddd\u4e0a\u6b21\u670d\u836f24 h\u670d\u836f1\u7247\uff0c48 h\u518d\u670d\u75281\u7247\uff0c\u8fd9\u662f\u5178\u578b\u7684\u201c2+1+1\u201dPrEP\u6309\u9700\u670d\u836f\u65b9\u6848\u3002\u5982\u679c\u201c2+1+1\u201dPrEP\u6309\u9700\u670d\u836f\u65b9\u6848\u7ed3\u675f\u524d\u518d\u6b21\u53d1\u751f\u9ad8\u5371\u6027\u884c\u4e3a\uff0c\u5219\u5ef6\u7eed\u6bcf\u5929\u670d\u75281\u7247\uff0c\u76f4\u81f3\u6700\u540e\u4e00\u6b21\u6027\u884c\u4e3a\u540e48 h\u3002<\/p>\n

\u56fd\u9645\u827e\u6ecb\u75c5\u534f\u4f1a\uff08IAS\uff09\u548cWHO\u6307\u5357\u5747\u63a8\u8350\uff0c\u6bcf\u65e5\u670d\u836f\u65b9\u6848\u9002\u7528\u4e8e\u5404\u7c7b\u9002\u5408\u4eba\u7fa4\uff0c\u800c\u6309\u9700\u670d\u7528\u65b9\u6848\u4ec5\u63a8\u8350\u7528\u4e8e\u7537\u6027\uff3b<\/sup>6,25<\/sup>\uff3d<\/sup>\u3002\u4f46\u6839\u636e\u73b0\u6709\u7814\u7a76\uff0c\u6bcf\u65e5\u670d\u836f\u65b9\u6848\u5728\u5404\u7c7b\u9002\u5408\u4eba\u7fa4\u5747\u8bc1\u5b9e\u5177\u6709\u826f\u597d\u7684\u9884\u9632HIV\u6548\u679c\u3002\u800c\u6309\u9700\u670d\u836f\u4ec5\u5728MSM\u548cTGM\u4e2d\u89c2\u5bdf\u5230\u826f\u597d\u6548\u679c\uff0c\u8fd9\u53ef\u80fd\u7531\u4e8e\u6b64\u7c7b\u7fa4\u4f53\u7684\u6027\u884c\u4e3a\u65b9\u5f0f\u4e3b\u8981\u4e3a\u809b\u4ea4\uff0c\u800c\u76f4\u80a0\u7ec4\u7ec7\u4e2d\u7684\u8840\u836f\u6d53\u5ea6\u6bd4\u5973\u6027\u9634\u9053\u5206\u6ccc\u7269\u7684\u6d53\u5ea6\u8fbe\u5230\u4fdd\u62a4\u6548\u679c\u7684\u65f6\u95f4\u66f4\u77ed\uff3b<\/sup>14,26-30<\/sup>\uff3d<\/sup>\u3002\u9700\u8981\u6ce8\u610f\u7684\u662f\uff0cTDF\/FTC\u4e0d\u63a8\u8350\u7528\u4e8eeGFR<60 mL\/min\u7684\u4eba\u7fa4\uff0cTAF\/FTC\u4e0d\u63a8\u8350\u7528\u4e8eeGFR<30 mL\/min\u7684\u4eba\u7fa4\u3002<\/p>\n

3.1.3\u3000\u968f\u8bbf\u9891\u6b21\u53ca\u9879\u76ee\u3000\u9002\u5408\u4eba\u7fa4\u5728\u5f00\u59cb\u53e3\u670dPrEP\u836f\u7269\u4ee5\u540e\uff0c\u5efa\u8bae\u5728\u7b2c1\u4e2a\u6708\u5185\u5b8c\u6210\u9996\u6b21\u968f\u8bbf\uff0c\u4ee5\u91cd\u590dHIV\u68c0\u6d4b\u786e\u5b9a\u9634\u6027\u72b6\u6001\u53ca\u8bc4\u4f30\u836f\u7269\u65e9\u671f\u4e0d\u826f\u53cd\u5e94\uff0c\u5e76\u8fdb\u884c\u4f9d\u4ece\u6027\u8bc4\u4f30\u548c\u6559\u80b2\u3002\u968f\u540e\u6bcf3\u4e2a\u6708\u968f\u8bbf\uff0c\u786e\u8ba4HIV\u53ca\u5176\u4ed6\u6027\u4f20\u64ad\u75be\u75c5\u611f\u67d3\u60c5\u51b5\uff0c\u8bc4\u4f30\u836f\u7269\u4e0d\u826f\u53cd\u5e94\u548c\u670d\u836f\u4f9d\u4ece\u6027\uff0c\u51b3\u5b9a\u662f\u5426\u7ee7\u7eed\u8fdb\u884cPrEP\u3002\u6240\u6709PrEP\u4eba\u7fa4\u5e94\u5b9a\u671f\u68c0\u6d4b\u80be\u529f\u80fd\u548cHBV\u6297\u539f\u6297\u4f53\uff0c\u5982\u4f7f\u7528TAF\/FTC\u8fd8\u9700\u68c0\u6d4b\u8840\u8102\u53ca\u76d1\u6d4b\u4f53\u91cd\u3002<\/p>\n

\u5e74\u9f84>50\u5c81\u6216\u8005\u57fa\u7ebfeGFR<90 mL\/min\u8005\uff0c\u5efa\u8bae\u6bcf6\u4e2a\u6708\u68c0\u67e5\u4e00\u6b21\u80be\u529f\u80fd\u3002\u5982\u679cPrEP\u4eba\u7fa4\u4f34\u6709\u5176\u4ed6\u5f71\u54cd\u80be\u529f\u80fd\u7684\u57fa\u7840\u75be\u75c5\uff08\u5982\u9ad8\u8840\u538b\u3001\u7cd6\u5c3f\u75c5\uff09\uff0c\u5219\u9700\u589e\u52a0\u80be\u529f\u80fd\u68c0\u6d4b\u9891\u7387\u5e76\u7eb3\u5165\u989d\u5916\u7684\u68c0\u6d4b\u6307\u6807\uff08\u5982\u5c3f\u86cb\u767d\uff09\u3002\u5982\u679ceGFR\u6301\u7eed\u4e0b\u964d\uff0c\u5e94\u8bc4\u4f30\u5176\u4ed6\u53ef\u80fd\u539f\u56e0\uff0c\u5982\u662f\u5426\u6b63\u5728\u670d\u7528\u9ad8\u5242\u91cf\u975e\u753e\u4f53\u7c7b\u6297\u708e\u836f\u7269\uff08NSAID\uff09\u6216\u4f7f\u7528\u86cb\u767d\u7c89\uff0c\u5e76\u8bf7\u80be\u75c5\u4e13\u79d1\u533b\u751f\u534f\u8bca\u3002<\/p>\n

3.1.4\u3000\u4e0d\u826f\u53cd\u5e94\u3000TDF\/FTC\u548cTAF\/FTC\u4f5c\u4e3aPrEP\u7528\u836f\u5177\u6709\u826f\u597d\u7684\u5b89\u5168\u6027\u548c\u8010\u53d7\u6027\u3002\u90e8\u5206\uff08<10%\uff09\u4eba\u7fa4\u4f1a\u51fa\u73b0\u201c\u542f\u52a8\u7efc\u5408\u5f81\u201d\uff0c\u8868\u73b0\u4e3a\u5728\u670d\u836f\u7269\u7684\u56db\u5468\u5185\u51fa\u73b0\u8f7b\u5ea6\u7684\u6076\u5fc3\u3001\u5934\u75db\u3001\u4f53\u91cd\u51cf\u8f7b\u6216\u5176\u4ed6\u75c7\u72b6\uff0c\u4f46\u5927\u591a\u6570\u75c7\u72b6\u56db\u5468\u540e\u4f1a\u6d88\u5931\u6216\u7f13\u89e3\uff3b<\/sup>6<\/sup>\uff3d<\/sup>\u3002TDF\u7684\u5e38\u89c1\u4e0d\u826f\u53cd\u5e94\u5305\u62ec\u5934\u75db\u3001\u8179\u6cfb\u3001\u75b2\u52b3\u3001\u80be\u529f\u80fd\u4e0d\u5168\u3001\u4e73\u9178\u4ee3\u8c22\u4e2d\u6bd2\u548c\u9aa8\u5bc6\u5ea6\u4e0b\u964d\uff3b<\/sup>31-32<\/sup>\uff3d<\/sup>\uff0cTDF\u5f15\u8d77\u80be\u529f\u80fd\u4e0d\u5168\u7684\u539f\u56e0\u53ef\u80fd\u662f\u8fd1\u7aef\u80be\u5c0f\u7ba1\u75c5\u53d8\u6240\u81f4\u3002TAF\u5728TDF\u7684\u57fa\u7840\u4e0a\u505a\u4e86\u6539\u826f\uff0c\u51cf\u5c11\u4e86\u7ecf\u80be\u810f\u4ee3\u8c22\u7684\u8d1f\u62c5\uff0c\u80be\u635f\u4f24\u53ca\u9aa8\u5bc6\u5ea6\u98ce\u9669\u5747\u663e\u8457\u4e0b\u964d\uff0c\u4f46\u5c1a\u672a\u6d88\u9664\u66ff\u8bfa\u798f\u97e6\u5e26\u6765\u7684\u98ce\u9669\uff0c\u540c\u65f6\u4e5f\u5b58\u5728\u5bfc\u81f4\u4f53\u91cd\u589e\u52a0\u53ca\u8840\u8102\u5f02\u5e38\u7684\u98ce\u9669\uff3b<\/sup>6,21,33-35<\/sup>\uff3d<\/sup>\u3002FTC\u7684\u5e38\u89c1\u4e0d\u826f\u53cd\u5e94\u5305\u62ec\u5934\u75db\u3001\u6076\u5fc3\u3001\u8179\u6cfb\u3001\u75b2\u52b3\u3001\u76ae\u80a4\u8272\u7d20\u6c89\u7740\u548c\u4e73\u9178\u4ee3\u8c22\u4e2d\u6bd2\u3002<\/p>\n

3.1.5\u3000\u505c\u836f\u53ca\u91cd\u65b0\u542f\u52a8\u3000\u53e3\u670dPrEP\u7684\u505c\u836f\u4e0e\u91cd\u65b0\u542f\u52a8\u5728\u771f\u5b9e\u4e16\u754c\u4e2d\u5747\u6781\u4e3a\u5e38\u89c1\uff0c\u7b26\u5408\u53e3\u670dPrEP\u4f7f\u7528\u7075\u6d3b\u3001\u4fbf\u6377\uff0c\u4e14\u4e0eHIV\u611f\u67d3\u98ce\u9669\u6539\u53d8\u76f8\u5339\u914d\u7684\u7279\u70b9\uff3b<\/sup>36<\/sup>\uff3d<\/sup>\u3002\u63d0\u4f9bPrEP\u7684\u4e13\u4e1a\u4eba\u5458\u5e94\u5728PrEP\u542f\u52a8\u524d\u4e0e\u4f7f\u7528\u8005\u63a2\u8ba8\u5728\u4f55\u79cd\u60c5\u51b5\u4e0b\u53ef\u505c\u6b62PrEP\u670d\u836f\u3001\u5982\u4f55\u5b89\u5168\u5730\u505c\u6b62PrEP\u670d\u836f\u3001\u4f55\u65f6\u9700\u8981\u91cd\u542fPrEP\u3002\u505c\u7528\u53e3\u670dPrEP\u836f\u7269\u5e38\u89c1\u539f\u56e0\u5305\u62ec\uff1aPrEP\u4eba\u7fa4\u610f\u613f\u3001\u6539\u53d8\u751f\u6d3b\u72b6\u51b5\u5bfc\u81f4HIV\u611f\u67d3\u98ce\u9669\u964d\u4f4e\u3001\u65e0\u6cd5\u5fcd\u53d7\u7684\u4e0d\u826f\u53cd\u5e94\u3001\u957f\u671f\u4e0d\u9075\u5b88\u89c4\u5b9a\u7684\u7ed9\u836f\u65b9\u6848\u6216\u5b89\u6392\u7684\u968f\u8bbf\u65f6\u95f4\uff0c\u6216\u53d1\u751fHIV\u611f\u67d3\u3002<\/p>\n

\u5bf9\u4e8e\u4f7f\u7528\u6bcf\u65e5\u670d\u836f\u65b9\u6848\u7684PrEP\u4eba\u7fa4\uff0c\u4e00\u65e6\u505c\u836f\u540e\u9700\u8981\u91cd\u65b0\u542f\u52a8\uff0c\u5efa\u8bae\u6309\u7167\u521d\u59cb\u542f\u52a8\u65b9\u5f0f\u8fde\u7eed\u670d\u75287\u5929\u540e\u624d\u53ef\u8fdb\u884cHIV\u9ad8\u5371\u884c\u4e3a\u3002\u5bf9\u4e8e\u6309\u9700\u670d\u7528\u65b9\u6848\u7684PrEP\u4eba\u7fa4\uff0c\u5982\u679c\u6700\u540e\u4e00\u6b21\u670d\u836f\u548c\u4e0b\u4e00\u6b21\u6027\u884c\u4e3a\u95f4\u9694<7\u5929\uff0c\u6062\u590d\u6bcf\u59291\u7247\uff0c\u76f4\u81f3\u6700\u540e\u4e00\u6b21\u6027\u884c\u4e3a\u540e48 h\u3002\u5982\u679c\u6700\u540e\u4e00\u6b21\u670d\u836f\u548c\u4e0b\u4e00\u6b21\u6027\u884c\u4e3a\u95f4\u9694\u22657\u5929\uff0c\u5219\u91cd\u65b0\u5f00\u59cb\u201c2+1+1\u201dPrEP\u6309\u9700\u670d\u836f\u65b9\u5f0f\u3002<\/p>\n

3.2\u3000\u957f\u6548\u65b9\u6848\u3000<\/strong><\/p>\n

3.2.1\u3000\u957f\u6548\u836f\u7269\u9009\u62e9\u30002021\u5e74\uff0cCAB\u7f13\u91ca\u6ce8\u5c04\u7528\u60ac\u6d6e\u6db2\uff08600 mg\uff0c\u6bcf8\u5468\u4e00\u6b21\uff09\u83b7\u7f8e\u56fdFDA\u6279\u51c6\u7528\u4e8e\u4f53\u91cd\u8d85\u8fc735 kg\uff0c12~18\u5c81\u7684\u9752\u5c11\u5e74\u548c\u6210\u4eba\uff0c\u6210\u4e3a\u9996\u6b3e\u7528\u4e8ePrEP\u7684\u957f\u6548\u6ce8\u5c04\u836f\u7269\u3002\u8be5\u65b9\u6848\u5df2\u7eb3\u5165\u56fd\u9645\u4e3b\u6d41\u6307\u5357\u63a8\u8350\uff0c\u5bf9\u4e8e\u80be\u529f\u80fd\u4e0d\u5168\u3001\u53e3\u670dPrEP\u65b9\u6848\u4f9d\u4ece\u6027\u4e0d\u4f73\u3001\u66f4\u503e\u5411\u4e8e\u9009\u62e9\u957f\u6548\u65b9\u6848\u7684\u4eba\u7fa4\u5c24\u5176\u9002\u7528\uff3b<\/sup>3,6-7<\/sup>\uff3d<\/sup>\u3002<\/p>\n

\u4e24\u9879\u5927\u578b\u2161b\u548c\u2162\u671f\u4e34\u5e8a\u7814\u7a76\uff08HPTN 083\u548cHPTN 084\uff09\u7ed3\u679c\u663e\u793a\uff0c\u76f8\u8f83\u4e8e\u6bcf\u65e5\u53e3\u670dTDF\/FTC\u65b9\u6848\uff0c\u957f\u6548CAB\u65b9\u6848\u5728MSM\u548cTGW\u4e2d\u4fdd\u62a4\u6548\u529b\u63d0\u9ad8\u4e8669%\uff0c\u5728\u987a\u6027\u522b\u5973\u6027\u4e2d\u4fdd\u62a4\u6548\u529b\u63d0\u9ad8\u4e8690%\uff0c\u5747\u8fbe\u5230\u4f18\u6548\u7684\u7ed3\u679c\uff3b<\/sup>37-38<\/sup>\uff3d<\/sup>\u3002Meta\u5206\u6790\u663e\u793a\uff0c\u8fd9\u4e24\u9879\u7814\u7a76\u4e2d\u76f8\u8f83\u4e8e\u53e3\u670dTDF\/FTC\u65b9\u6848\uff0c\u957f\u6548CAB\u65b9\u6848\u4e00\u5171\u964d\u4f4e\u4e8679%\u7684HIV\u611f\u67d3\u98ce\u9669\uff0c\u8fd9\u4e3b\u8981\u662f\u53e3\u670d\u836f\u7269\u4f9d\u4ece\u6027\u4e0d\u4f73\u6240\u5bfc\u81f4\u3002\u800c\u5982\u679c\u5c06\u6240\u6709PrEP\u4f7f\u7528\u8005\u4ece\u53e3\u670dPrEP\u65b9\u6848\u8f6c\u4e3aCAB\u957f\u6548\u6ce8\u5c04\uff0c\u53ef\u4ee5\u989d\u5916\u964d\u4f4e3%\u7684\u65b0\u53d1\u611f\u67d3\u7387\u3002\u56e0\u6b64\uff0c\u957f\u6548\u836f\u7269PrEP\u65b9\u6848\uff0c\u5c06\u4e3aHIV\u611f\u67d3\u9ad8\u98ce\u9669\u4eba\u7fa4\u7684\u9884\u9632\u5e26\u6765\u66f4\u591a\u9009\u62e9\u548c\u83b7\u76ca\uff3b<\/sup>3<\/sup>\uff3d<\/sup>\u3002<\/p>\n

3.2.2\u3000\u7ed9\u836f\u65b9\u6848\u3000CAB\u4f7f\u7528\u65b9\u5f0f\u4e3a\u81c0\u90e8\u808c\u8089\u6ce8\u5c04600 mg\/\u6b21\uff0c\u76ee\u524dPrEP\u9002\u5e94\u8bc1\u4ec5\u6709\u6bcf8\u5468\u808c\u6ce8\u4e00\u6b21\u7684\u65b9\u6848\uff0c\u5176\u4e2d\u524d\u4e24\u6b21\u6ce8\u5c04\u95f4\u96944\u5468\uff0c\u7b2c3\u6b21\u6ce8\u5c04\u5f00\u59cb\u6bcf8\u5468\u4e00\u6b21\u3002\u867d\u7136\u4e34\u5e8a\u7814\u7a76\u4e2d\u5747\u8bbe\u7f6e\u4e861\u4e2a\u6708\u5de6\u53f3\u7684\u53e3\u670d\u5bfc\u5165\u671f\uff0c\u4f46\u7531\u4e8e\u5728\u5bfc\u5165\u671f\u53ca\u7814\u7a76\u7684\u6ce8\u5c04\u9636\u6bb5\u5747\u672a\u53d1\u73b0\u5b89\u5168\u95ee\u9898\uff0c\u56e0\u6b64\u5728\u5f00\u59cb\u4f7f\u7528CAB\u957f\u6548\u65b9\u6848PrEP\u65f6\u65e0\u9700\u53e3\u670d\u5bfc\u5165\u3002\u5bf9\u4e8e\u7279\u522b\u62c5\u5fc3\u4e0d\u826f\u53cd\u5e94\u7684PrEP\u4eba\u7fa4\uff0c\u53ef\u9009\u62e9\u6027\u5730\u4f7f\u7528\u53e3\u670d\u5bfc\u5165\uff0c\u4ee5\u51cf\u8f7b\u4f7f\u7528\u957f\u6548CAB\u6ce8\u5c04\u5242\u7684\u7126\u8651\u3002\u7ed9\u836f\u65b9\u6848\u4e3a\u5728\u7b2c1\u6b21\u6ce8\u5c04\u4e4b\u524d\uff0c\u6bcf\u65e5\u4e00\u6b21\u53e3\u670dCAB 30 mg\u7247\u5242\u6301\u7eed4\u5468\u3002<\/p>\n

\u5728\u968f\u8bbf\u9636\u6bb5\uff0c\u53ef\u5728\u8ba1\u5212\u7ed9\u836f\u65e5\u671f\u524d\u540e7\u5929\u5185\u63a5\u53d7\u6ce8\u5c04\uff0c\u4f46\u5982\u679c\u8d85\u8fc7\u8ba1\u5212\u7ed9\u836f\u65e5\u671f7\u5929\u4ecd\u672a\u8fdb\u884c\u6ce8\u5c04\uff0c\u5219\u9700\u4f7f\u7528\u6bcf\u65e5\u53e3\u670dPrEP\u65b9\u6848\u8fdb\u884c\u6865\u63a5\uff0c\u76f4\u5230\u4e0b\u6b21\u6ce8\u5c04\u65b9\u53ef\u505c\u6b62\uff0c\u9700\u8981\u6ce8\u610f\u7684\u662f\u76ee\u524d\u4e0d\u63a8\u8350CAB\u7247\u5242\u7528\u4e8ePrEP\u3002<\/p>\n

\u867d\u7136CAB\u957f\u6548\u65b9\u6848\u80fd\u591f\u6709\u6548\u964d\u4f4eHIV\u611f\u67d3\u98ce\u9669\uff0c\u4f46\u76ee\u524d\u4ecd\u65e0\u76f8\u5173\u7684\u4e34\u5e8a\u8bd5\u9a8c\u6570\u636e\u6765\u4f30\u8ba1\u4ece\u5f00\u59cb\u6ce8\u5c04\u5230\u5bf9HIV\u83b7\u5f97\u6700\u5927\u4fdd\u62a4\u7684\u65f6\u95f4\uff0c\u6307\u5357\u8ba4\u4e3a\u53ef\u80fd\u662f\u5728\u7b2c\u4e00\u6b21\u6ce8\u5c04\u540e\u7b2c7\u5929\u5de6\u53f3\u80fd\u8fbe\u5230\u4fdd\u62a4\u6d53\u5ea6\uff0c\u56e0\u6b64\u5efa\u8bae\u7b2c\u4e00\u6b21\u6ce8\u5c047\u5929\u540e\u65b9\u53ef\u8fdb\u884cHIV\u9ad8\u5371\u884c\u4e3a\u3002<\/p>\n

3.2.3\u3000\u968f\u8bbf\u9891\u6b21\u3000HIV\u68c0\u6d4b\u7ed3\u679c\u8868\u660e\u6ca1\u6709HIV\u611f\u67d3\u7684PrEP\u4eba\u7fa4\u5c31\u53ef\u8003\u8651\u5f00\u59cbCAB\u957f\u6548\u65b9\u6848\uff0c\u7531\u4e8eCAB\u9700\u8981\u5728\u533b\u7597\u673a\u6784\u8fdb\u884c\u808c\u6ce8\uff0c\u56e0\u6b64\u968f\u8bbf\u9891\u7387\u4e0e\u6ce8\u5c04\u9891\u7387\u4e00\u81f4\uff0c\u6bcf\u6b21\u968f\u8bbf\u5747\u9700\u8981\u91cd\u590dHIV\u68c0\u6d4b\u786e\u5b9a\u9634\u6027\u72b6\u6001\u53ca\u8bc4\u4f30\u836f\u7269\u4e0d\u826f\u53cd\u5e94\u7b49\u5176\u4ed6\u60c5\u51b5\u3002\u5efa\u8bae\u6bcf4~6\u4e2a\u6708\u8bc4\u4f30\u5176\u4ed6\u6027\u4f20\u64ad\u75be\u75c5\u611f\u67d3\u60c5\u51b5\uff0c\u6bcf\u5e74\u8fdb\u884c\u4e00\u6b21HCV\u6297\u4f53\u68c0\u6d4b\u3002\u76ee\u524d\u6570\u636e\u663e\u793aCAB\u5bf9\u80be\u529f\u80fd\u53ca\u4ee3\u8c22\u65e0\u660e\u663e\u5f71\u54cd\uff0c\u56e0\u6b64\u4e00\u822c\u4e0d\u9700\u8981\u76d1\u6d4b\u80be\u529f\u80fd\u53ca\u4ee3\u8c22\u6307\u6807\u53d8\u5316\u3002<\/p>\n

3.2.4\u3000\u4e0d\u826f\u53cd\u5e94\u3000\u5728\u4e34\u5e8a\u8bd5\u9a8c\u4e2d\uff0cCAB\u5e38\u89c1\u4e0d\u826f\u53cd\u5e94\u4e0eTDF\/FTC\u76f8\u4f3c\uff0c\u5982\u5934\u75db\u3001\u8179\u6cfb\u3001\u6076\u5fc3\u548c\u75b2\u52b3\u3002\u4f46\u6ce8\u5c04CAB\u540e\u7ecf\u5e38\u51fa\u73b0\u6ce8\u5c04\u90e8\u4f4d\u53cd\u5e94\uff08ISR\uff09\uff0c\u5305\u62ec\u75bc\u75db\u3001\u538b\u75db\u3001\u786c\u7ed3\u7b49\u3002\u8fd9\u4e9bISR\u4e00\u822c\u4e3a\u8f7b\u5ea6\u6216\u4e2d\u5ea6\uff0c\u4ec5\u6301\u7eed\u51e0\u5929\uff0c\u591a\u53d1\u751f\u5728\u524d2~3\u6b21\u6ce8\u5c04\u540e\u3002\u4f7f\u7528\u8005\u53ef\u5728\u6ce8\u5c04\u524d\u6216\u6ce8\u5c04\u540e\u51e0\u5c0f\u65f6\u5185\u81f31~2\u5929\u5185\u670d\u7528\u975e\u5904\u65b9\u6b62\u75db\u836f\uff0c\u5728\u6ce8\u5c04\u540e\u5c40\u90e8\u70ed\u6577\u6216\u4f7f\u7528\u52a0\u70ed\u57ab15~20 min\uff0c\u5747\u53ef\u4ee5\u6709\u6548\u7f13\u89e3ISR\u3002<\/p>\n

3.2.5\u3000\u8f6c\u6362\u3001\u505c\u836f\u53ca\u91cd\u65b0\u542f\u52a8\u3000\u4f7f\u7528CAB\u957f\u6548\u65b9\u6848\u7684PrEP\u4eba\u7fa4\uff0c\u5982\u679c\u4f7f\u7528\u53e3\u670d\u65b9\u6848\u6865\u63a5\u65f6\u95f4\u8d85\u8fc78\u5468\uff0c\u90a3\u4e48\u4e0b\u6b21\u6ce8\u5c04\u65f6\u9700\u8981\u91cd\u65b0\u5f00\u59cb\u542f\u52a8\uff0c\u524d\u4e24\u6b21\u6ce8\u5c04\u95f4\u96944\u5468\uff0c\u7b2c3\u6b21\u6ce8\u5c04\u5f00\u59cb\u6bcf8\u5468\u4e00\u6b21\u3002\u5982\u679cPrEP\u4eba\u7fa4\u8ba1\u5212\u8f6c\u6362\u4e3a\u6bcf\u65e5\u53e3\u670d\u65b9\u6848\uff0c\u53ef\u4ece\u8ba1\u5212\u7ed9\u836f\u65e5\u671f\u76f4\u63a5\u8f6c\u6362\u4e3aTDF\/FTC\u6216\u8005TAF\/FTC\u3002\u5bf9\u4e8e\u4f7f\u7528\u53e3\u670dPrEP\u65b9\u6848\u7684\u4eba\u7fa4\uff0c\u53ea\u8981HIV-1\u6838\u9178\u68c0\u6d4b\u7ed3\u679c\u8bc1\u5b9e\u4ed6\u4eec\u4ecd\u7136\u662fHIV\u9634\u6027\uff0c\u5c31\u53ef\u4ee5\u5f00\u59cb\u8f6c\u4e3a\u4f7f\u7528CAB\u957f\u6548\u65b9\u6848\u3002<\/p>\n

3.3\u3000\u8fbe\u5339\u97e6\u6797\u9634\u9053\u73af<\/strong>\uff08dapivirine vaginal ring\uff0cDVR\uff09\u30002021\u5e74WHO\u5efa\u8bae\u5c06DVR\u4f5c\u4e3a\u4e00\u79cd\u989d\u5916\u7684PrEP\u9009\u62e9\u63d0\u4f9b\u7ed9HIV\u9ad8\u98ce\u9669\u66b4\u9732\u7684\u5973\u6027\uff0c\u76ee\u524d\u5df2\u7ecf\u6709\u4e00\u4e9b\u56fd\u5bb6\u5f00\u59cb\u5c06DVR\u7eb3\u5165\u5176\u56fd\u5bb6\u6307\u5357\u4e2d\uff0c\u4f46\u4e3b\u8981\u96c6\u4e2d\u5728\u975e\u6d32\u56fd\u5bb6\uff3b<\/sup>39<\/sup>\uff3d<\/sup>\u3002\u6211\u56fd\u76ee\u524d\u5c1a\u672a\u6279\u51c6\u8be5\u836f\u4e0a\u5e02\u3002\u8fbe\u5339\u97e6\u6797\u662f\u4e00\u79cd\u65b0\u578bNNRTIs\uff0c\u9634\u9053\u73af\u7531\u7845\u6811\u8102\u5236\u6210\uff0c\u6613\u4e8e\u5f2f\u66f2\u548c\u63d2\u5165\u3002\u8be5\u73af\u901a\u5e38\u572828\u5929\u4e4b\u5185\u5c06\u8fbe\u5339\u97e6\u6797\u4ece\u9634\u9053\u73af\u4e2d\u7f13\u6162\u91ca\u653e\u5230\u9634\u9053\u4e2d\u800c\u8d77\u4f5c\u7528\u3002<\/p>\n

\u4e24\u9879\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u663e\u793a\u5728\u610f\u5411\u6027\u6cbb\u7597\u5206\u6790\u4e2d\uff0cDVR\u80fd\u591f\u51cf\u5c11\u7ea630%\u7684HIV\u611f\u67d3\u98ce\u9669\uff3b40-41\uff3d<\/sup>\uff0c\u8fbe\u5339\u97e6\u6797\u4f5c\u7528\u4e8e\u5c40\u90e8\uff0c\u5168\u8eab\u5438\u6536\u7387\u5f88\u4f4e\uff3b42\uff3d<\/sup>\u3002\u8fd9\u4e9b\u8bd5\u9a8c\u663e\u793a\u5b9e\u9a8c\u7ec4\u548c\u5b89\u6170\u5242\u7ec4\u5728\u4e0e\u598a\u5a20\u6709\u5173\u7684\u4e0d\u826f\u4e8b\u4ef6\u3001\u5a74\u5e7c\u513f\u7ed3\u5c40\u65b9\u9762\u6ca1\u6709\u660e\u663e\u7684\u5dee\u5f02\u3002\u7136\u800c\uff0c\u7531\u4e8e\u598a\u5a20\u5987\u5973\u7684\u6570\u91cf\u4e0d\u591a\uff0c\u672a\u6765\u8fd8\u9700\u8981\u66f4\u591a\u7684\u6570\u636e\uff3b39\uff3d<\/sup>\u3002<\/p>\n<\/section>\n

\n
\n
4 \u7279\u6b8a\u4eba\u7fa4\u7684\u7ba1\u7406<\/strong><\/section>\n
<\/section>\n<\/section>\n
4.1\u3000\u80be<\/strong>\u529f\u80fd\u635f\u4f24\u4eba\u7fa4<\/strong>\u3000\u5728\u5f00\u59cb\u4f7f\u7528\u53e3\u670d\u836f\u7269\u8fdb\u884cPrEP\u4e4b\u524d\uff0c\u4e34\u5e8a\u533b\u751f\u5fc5\u987b\u5bf9\u6c42\u8be2\u8005\u7684\u80be\u529f\u80fd\u8fdb\u884c\u8bc4\u4f30\uff0c\u56e0\u4e3a\u5bf9\u4e8e\u53e3\u670d\u836f\u7269TDF\/FTC\u6216TAF\/FTC\uff0c\u80be\u529f\u80fd\u4e0b\u964d\u662f\u4e00\u4e2a\u6f5c\u5728\u7684\u5b89\u5168\u6027\u95ee\u9898\u3002eGFR\u226560 mL\/min\u7684\u6c42\u8be2\u8005\u53ef\u4f7f\u7528\u53e3\u670dTDF\/FTC\u7528\u4e8ePrEP\uff0ceGFR\u226530 mL\/min\u7684\u6c42\u8be2\u8005\u53ef\u9009\u62e9\u4f7f\u7528\u53e3\u670dTAF\/FTC\uff0c\u5728\u968f\u8bbf\u8fc7\u7a0b\u4e2d\u4e5f\u9700\u8981\u5bc6\u5207\u68c0\u6d4b\u80be\u529f\u80fd\u53d8\u5316\u3002eGFR<30 mL\/min\u7684PrEP\u4eba\u7fa4\u4e0d\u5e94\u8be5\u4f7f\u7528\u4efb\u4f55\u53e3\u670d\u65b9\u6848\u8fdb\u884cPrEP\uff0c\u56e0\u4e3a\u5728\u4e34\u5e8a\u8bd5\u9a8c\u4e2d\u6ca1\u6709\u8bc4\u4f30\u542b\u66ff\u8bfa\u798f\u97e6\u65b9\u6848\u5bf9\u8fd9\u7c7b\u4eba\u7fa4\u7684\u5b89\u5168\u6027\uff0c\u540c\u65f6\u5bf9\u4e8e\u6709\u91cd\u5927\u80be\u810f\u75be\u75c5\u7684PrEP\u60a3\u8005\uff0c\u4e0d\u5efa\u8bae\u51cf\u5c11TDF\/FTC\u6216TAF\/FTC\u7684\u5242\u91cf\u3002\u5bf9\u4e8e\u4e0d\u63a8\u8350\u4f7f\u7528\u66ff\u8bfa\u798f\u97e6\u7684\u4e25\u91cd\u80be\u75c5\u4eba\u7fa4\uff08\u5982eGFR<30 mL\/min\uff09\uff0c\u53ef\u8003\u8651\u4f7f\u7528CAB\u957f\u6548\u65b9\u6848\u30024.2\u3000\u6ce8<\/strong>\u5c04\u6bd2\u54c1\u4eba\u7fa4<\/strong>\u3000\u9488\u5bf9\u6ce8\u5c04\u6bd2\u54c1\u7684\u6210\u4eba\u548c\u9752\u5c11\u5e74\uff0c\u5efa\u8bae\u4f7f\u7528\u6bcf\u65e5\u670d\u7528TDF\/FTC\u7684\u53e3\u670d\u65b9\u6848\u8fdb\u884cPrEP\uff0c\u7814\u7a76\u6570\u636e\u8bc1\u660e\u6bcf\u65e5\u670d\u836f\u65b9\u6848\u80fd\u591f\u6709\u6548\u964d\u4f4eHIV\u611f\u67d3\u98ce\u9669\uff0c\u662f\u8fd9\u7c7b\u4eba\u7fa4\u7684\u9996\u9009\u3002\u76ee\u524d\u5c1a\u4e0d\u6e05\u695aCAB\u957f\u6548\u65b9\u6848\u662f\u5426\u80fd\u6709\u6548\u9884\u9632\u9759\u8109\u6ce8\u5c04\u9014\u5f84\u611f\u67d3HIV\u3002<\/p>\n

4.3\u3000HIV<\/strong>\u5355\u9633\u5bb6\u5ead\u3000<\/strong>\u5bf9\u4e8eHIV\u5355\u9633\u5bb6\u5ead\uff0cHIV\u9633\u6027\u4e00\u65b9\u63a5\u53d7\u6297\u75c5\u6bd2\u6cbb\u7597\u4e14\u75c5\u6bd2\u8fbe\u5230\u6301\u7eed\u6291\u5236\uff08\u75c5\u6bd2\u8f7d\u91cf<200\u62f7\u8d1d\/mL\uff09\u662fHIV\u5355\u9633\u5bb6\u5ead\u5907\u5b55\u7684\u5173\u952e\uff3b<\/sup>43<\/sup>\uff3d<\/sup>\u3002\u7136\u800c\u4e00\u90e8\u5206\u4eba\u7fa4\u53ef\u80fd\u7531\u4e8eHIV\u9633\u6027\u4e00\u65b9\u75c5\u6bd2\u8f7d\u91cf\u672a\u8fbe\u5230\u6291\u5236\u3001\u75c5\u6bd2\u8f7d\u91cf\u672a\u77e5\u3001\u6709\u5176\u4ed6\u6027\u4f34\u4fa3\uff0c\u6216\u8005\u5e0c\u671b\u83b7\u5f97\u989d\u5916\u4fdd\u62a4\u7b49\u8981\u6c42\u4f7f\u7528PrEP\uff0c\u5373\u4f7f\u5176\u611f\u67d3HIV\u7684\u6027\u4f34\u4fa3\u5df2\u8fbe\u5230\u5e76\u7ef4\u6301\u75c5\u6bd2\u8f7d\u91cf\u6291\u5236\uff0c\u4e5f\u4e0d\u5e94\u62d2\u7edd\u63d0\u4f9bPrEP\u3002HIV\u5355\u9633\u5bb6\u5ead\u53ef\u4ee5\u9009\u62e9\u6bcf\u65e5\u53e3\u670d\u65b9\u6848\u6216\u8005CAB\u957f\u6548\u65b9\u6848\u8fdb\u884cPrEP\u3002<\/p>\n

\n
5 PrEP\u4eba\u7fa4\u53d1\u751fHIV\u611f\u67d3<\/strong><\/section>\n
<\/section>\n<\/section>\n
\u00a0<\/section>\n

\u89c4\u5f8b\u8fdb\u884cPrEP\u671f\u95f4\u611f\u67d3HIV\u7684\u60c5\u51b5\u975e\u5e38\u7f55\u89c1\uff0c\u4e0d\u8fc7\u968f\u7740PrEP\u7684\u63a5\u53d7\u5ea6\u9010\u6e10\u63d0\u9ad8\u548c\u4f7f\u7528\u4eba\u7fa4\u7684\u6269\u5927\uff0c\u53d1\u751fHIV\u611f\u67d3\u7684\u60c5\u51b5\u4e5f\u4e0d\u65ad\u51fa\u73b0\u3002\u5f53PrEP\u4eba\u7fa4\u5728\u968f\u8bbf\u8fc7\u7a0b\u4e2d\u6216\u8005\u505c\u836f\u540e\u51fa\u73b0HIV\u68c0\u6d4b\u7ed3\u679c\u4e0d\u660e\u786e\uff0c\u65e0\u8bba\u662f\u5728\u7b5b\u67e5\u65f6\uff0c\u8fd8\u662f\u5728\u670d\u7528\u53e3\u670d\u836f\u7269\u6216\u63a5\u53d7CAB\u6ce8\u5c04\u4f5c\u4e3a\u9884\u9632\u63aa\u65bd\u671f\u95f4\uff0c\u90fd\u9700\u6839\u636e\u6211\u56fd\u827e\u6ecb\u75c5\u8bca\u7597\u6307\u5357\u4e2d\u89c4\u5b9a\u7684\u8bca\u65ad\u539f\u5219\u8fdb\u884c\u8bc4\u4f30\uff3b<\/sup>47<\/sup>\uff3d<\/sup>\uff0c\u786e\u8ba4HIV\u611f\u67d3\u72b6\u6001\uff0c\u786e\u8bca\u540e\u6309\u7167\u521d\u6cbb\u60a3\u8005\u8fdb\u884c\u7ba1\u7406\u3002<\/p>\n

PrEP\u4eba\u7fa4\u53d1\u751fHIV\u611f\u67d3\u540e\u5efa\u8bae\u5b8c\u5584HIV\u8010\u836f\u68c0\u6d4b\uff0c\u5728\u8010\u836f\u7ed3\u679c\u51fa\u6765\u524d\uff0c\u4f7f\u7528\u53e3\u670dPrEP\u65b9\u6848\u7684\u60a3\u8005\u53ef\u4f7f\u7528\u542b\u4e8c\u4ee3\u6574\u5408\u9176\u7684\u4e09\u836f\u65b9\u6848\u8fdb\u884c\u521d\u59cb\u6cbb\u7597\uff0c\u800c\u4f7f\u7528CAB\u957f\u6548\u65b9\u6848\u7684\u60a3\u8005\u5efa\u8bae\u4f7f\u7528\u542b\u86cb\u767d\u9176\u7684\u4e09\u836f\u65b9\u6848\u3002\u5c3d\u7ba1PrEP\u7684\u5e7f\u6cdb\u4f7f\u7528\u53ef\u80fd\u4f1a\u589e\u52a0HIV\u611f\u67d3\u8005\u6cbb\u7597\u524d\u8010\u836f\u7684\u60c5\u51b5\uff0c\u4f46\u66f4\u91cd\u8981\u7684\u662fPrEP\u80fd\u591f\u51cf\u5c11HIV\u611f\u67d3\u7684\u98ce\u9669\uff0c\u4ece\u800c\u51cf\u5c11\u56e0HIV\u611f\u67d3\u800c\u5bfc\u81f4\u7684\u6b7b\u4ea1\u3002<\/p>\n

\"\"<\/p>\n<\/section>\n<\/section>\n<\/section>\n","protected":false},"excerpt":{"rendered":"\u827e\u6ecb\u75c5\u963b\u65ad\u836f\u54ea\u91cc\u8d2d\u4e70\uff0c\u827e\u6ecb\u75c5\u963b\u65ad\u836f\u4ef7\u683c\uff0c\u827e\u6ecb\u75c5\u963b\u65ad\u836f\u54c1\u9500\u552e\u673a\u6784\uff1f","protected":false},"author":2,"featured_media":4058,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[5,3,4,57],"tags":[209,170,52,54],"_links":{"self":[{"href":"http:\/\/baijianyy.cn\/index.php?rest_route=\/wp\/v2\/posts\/4056"}],"collection":[{"href":"http:\/\/baijianyy.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/baijianyy.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/baijianyy.cn\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"http:\/\/baijianyy.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=4056"}],"version-history":[{"count":2,"href":"http:\/\/baijianyy.cn\/index.php?rest_route=\/wp\/v2\/posts\/4056\/revisions"}],"predecessor-version":[{"id":4060,"href":"http:\/\/baijianyy.cn\/index.php?rest_route=\/wp\/v2\/posts\/4056\/revisions\/4060"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/baijianyy.cn\/index.php?rest_route=\/wp\/v2\/media\/4058"}],"wp:attachment":[{"href":"http:\/\/baijianyy.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=4056"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/baijianyy.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=4056"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/baijianyy.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=4056"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}

5\uff09 \u4f60\u662f\u5426\u591a\u6b21\u4f7f\u7528\u8fc7\u66b4\u9732\u540e\u9884\u9632\uff08PEP<\/a>\uff09\u63aa\u65bd\u9884\u9632\u901a\u8fc7\u6027\u4f20\u64ad\u9014\u5f84\u6216\u9759\u8109\u6ce8\u5c04\u4f20\u64ad\u9014\u5f84\u7684HIV\u611f\u67d3\uff1f<\/p>\n