在非职业性艾滋病毒暴露后的暴露后预防:临床,伦理和政策考虑
1Center for AIDS Prevention Studies, University of California, San Francisco, USA.
JAMA
|December 8, 1998
概括
医疗保健提供者可能会建议在偶尔接触人类免疫缺陷病毒 (HIV) 时进行暴露后预防 (PEP),类似于职业风险. 对于持续或低风险的风险,建议使用风险降低计划.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 抗病毒疗法 抗病毒疗法
背景情况:
- 最近抗病毒治疗的进步和CDC的指导方针促进了医护人员的暴露后预防 (PEP).
- 医疗保健专业人员面临越来越多的有关PEP的人类免疫缺陷病毒 (HIV) 暴露性接触和注射药物使用的PEP调查.
研究的目的:
- 评估推PEP对于非职业性艾滋病毒暴露的适当性.
- 根据传播风险和当地艾滋病毒流行率指导临床医生为患者提供PEP决策的建议.
主要方法:
- 从职业PEP建议数据推断到偶尔性接触和注射药物使用暴露的数据.
- 对不同暴露类型的艾滋病毒传播概率的评估.
- 考虑当地艾滋病毒血清流行数据,以提供知情的患者咨询.
主要成果:
- 零星的性或注射药物暴露带有与职业皮肤暴露相比的传播风险,这表明PEP可能是合适的.
- 持续的或低风险的风险应用于风险降低计划,而不是PEP.
- 基于当地数据的临床判断对于患者对PEP的决策至关重要.
结论:
- 对于零星的,高风险的非职业艾滋病毒暴露,可以考虑PEP,反映职业指南.
- 风险降低策略对于持续或较低风险的个人来说至关重要.
- 针对PEP的有针对性的公共卫生干预措施应集中在患病率高的地区,因为预防性治疗覆盖范围有限.
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