艾滋病毒在急性感染期间的诊断:长效暴露前预防的含义和其他不断变化的挑战
Tamara Elliott1,2,3, Daniel Bradshaw1,3,4, Sarah Fidler1,2,3
1Imperial College London, department of infectious disease, Faculty of Medicine.
Current opinion in HIV and AIDS
|February 18, 2025
概括
在暴露前预防 (PrEP) 中,艾滋病毒检测可能具有挑战性. 新的长效注射剂可能会导致不典型的测试结果,可能导致错过诊断. 需要负担得起和准确的艾滋病毒检测策略,特别是在资源较低的环境中.
科学领域:
- 传染性疾病 传染性疾病
- 病毒学 病毒学
- 公共卫生 公共卫生
背景情况:
- 艾滋病毒检测算法可能不会准确地解释使用艾滋病毒暴露前预防 (PrEP) 的人的结果.
- 新兴的艾滋病毒预防药物,特别是长效注射剂,对诊断准确性提出了独特的挑战.
- 本综述探讨了现代艾滋病毒预防策略的背景下,艾滋病毒检测的复杂性.
研究的目的:
- 审查使用艾滋病毒预防剂的个人与艾滋病毒检测相关的挑战.
- 突出艾滋病毒检测性能与暴露前预防 (PrEP) 的潜在差异.
- 鉴定由于测试算法局限性的错误阴性或错误阳性HIV结果的风险.
主要方法:
- 对评估长效注射PrEP (cabotegravir,lenacapavir) 的大型随机对照试验的审查.
- 对注射PrEP的个人报告的非典型HIV诊断测试结果的分析.
- 探索"长效早期病毒抑制" (LEVI) 综合征.
主要成果:
- 注射PrEP的疗效高于口服PrEP,但可能导致HIV耐药性.
- 在注射PrEP的个人中观察到非典型的HIV测试结果,包括抗体反应延迟和测试逆转 (LEVI综合征).
- 核酸放大试验可以改善诊断,但在资源有限的环境中往往是不可行的.
结论:
- 在使用预防剂的个体中,准确的艾滋病毒诊断至关重要.
- 为低收入和中等收入国家制定负担得起和实用的艾滋病毒检测策略至关重要.
- 需要进一步的研究,以优化艾滋病毒检测在先进的艾滋病毒预防的时代.
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