HIV职业暴露后预防（参考）.pptVIP

* 暴露后感染HIV抗体阳转规律 在暴露平均25天时，81%的人有急性感染症状 95%的感染者出现抗体阳转平均时间为65天 有5%病例在6个月以后、12个月以内出现抗体阳转 * 暴露后监测时间要求 HIV抗体的监测应在暴露发生后立刻、6周、12周和6个月，甚至12个月进行 如有必要可检测P24抗原和病毒栽量 监测还应包括对所用药物不良反应的监测。 * 不良反应的监测 实验室检测：CBC, 肝功、肾功、血糖（如果使用PI）。 基线和 PEP后2周进行化验。 其它化验视情况而定 如有毒性反应，向专家咨询，可考虑调整PEP用药方案。 * 安全事故的报告和检测 各省（自治区、直辖市）HIV应急事件处理专家组，由有关专家组成。 向主管领导及省HIV应急事件处理专家组报告 向中国疾病预防控制中心性病艾滋病预防控制中心报告 * 安全事故登记 建立“HIV检测实验室人员及临床医护保健人员职业暴露登记表” 记录处理方法及处理经过（包括赴现场专家或领导）； 详细记录有无治疗用药情况、首次用药时间（暴露后几小时或几天）、药物毒副作用情况（包括肝、肾功能化验结果）； 定期检测的日期、检测项目和结果。 * 必威体育官网网址制度 无论暴露事故大小，都要注意为涉及事故的暴露者做好必威体育官网网址工作。 * PET药品储备 储备千日，用在一时！ 一定要有PEP药品储备!!! * The selection of a drug regimen for HIV PEP must balance the risk for infection against the potential toxicities of the agent(s) used. Because PEP is potentially toxic, its use is not justified for exposures that pose a negligible risk for transmission (Tables 1 and 2). The initial HIV PEP regimens recommended in these guidelines should be viewed as suggestions that can be changed if additional information is obtained concerning the source of the occupational exposure (e.g., possible treatment history or antiretroviral drug resistance) or if expert consultation is provided. Given the complexity of choosing and administering HIV PEP, whenever possible, consultation with an infectious diseases consultant or another physician who has experience with antiretroviral agents is recommended, but it should not delay timely initiation of PEP. Consideration should be given to the comparative risk represented by the exposure and information regarding the exposure source, including history of and response to antiretroviral therapy based on clinical response, CD4+ T-cell counts, viral load measurements, and current disease stage. When the source person’s virus is known or suspected to be resistant to one or more of the drugs considered for the PEP regimen, the selection of drugs to which the source person’s virus is unlikely to be resistant is recommended; expert consultation is advised. If this informa