Chinese guidelines for diagnosis and treatment of HIV/AIDS (2018)

Abstract

Abstract: Acquired immunodeficiency syndrome (AIDS) is an important public health problem in China. In 2005, the first edition of the guidelines for the diagnosis and treatment of AIDS was formulated by the AIDS Professional Group of Society of Infectious Diseases of Chinese Medical Association, which was updated in 2011 and 2015, respectively. The fourth edition of the guidelines in 2018 is revised on the basis of the third edition and updated according to national clinical practice and the latest research results. The new research progress in opportunistic infections and human immunodeficency virus(HIV) associated cancers, antiretroviral therapy, HIV post-exposure prophylaxis, and prevention of mother to child transmission were updated in these guidelines. In the 2018 edition, pre-exposure prophylaxis is mentioned for the first time. The strategy of whole course management of HIV infection is put forward and how to do the whole course management of HIV infection is explained in this version. These guidelines will be updated regularly according to the latest clinical evidence.

Key words: Acquired immunodeficiency syndrome, Human immunodeficiency virus, Diagnosis, Treatment, Guideline

References

[1] 中华医学会感染病学分会艾滋病学组. 艾滋病诊疗指南第三版(2015版)[J]. 中华临床感染病杂志,2015,10(8):385-401.
[2] World Health Organization. WHO HIV update: global epidemic and progress in scale up and policy uptake[EB/OL]. http://www.who.int/hiv/data/en/.
[3] World Health Organization. Global scientific leaders explore strategies to achieve the 90-90-90 targe[R/OL]. http://www.unaids.org/en/resources/presscentre/featurestories/2015/july/20150722_90-90-90-target.
[4] 吴尊友. 我国艾滋病经性传播新特征与防治面临的挑战[J].中华流行病学杂志,2018,39(6):707-709.
[5] 中国疾病预防控制中心. 全国艾滋病检测技术规范(2015年修订版)[J].中国病毒病杂志,2016,6(6):401-427.
[6] 荆凡辉, 吕玮, 李太生. HIV感染者免疫功能重建新视角:CD4/CD8比值[J].中国艾滋病性病,2018,24:643-646.
[7] Li Y, Han Y, Xie J, et al.CRF01_AE subtype is associated with X4 tropism and fast HIV progression in Chinese patientsinfected through sexual transmission[J]. AIDS, 2014, 28(4): 521-530.
[8] Su B, Moog C.Which antibody functions are important for an HIV vaccine?[J]. Front Immunol, 2014, 5:289.
[9] Panel on opportunistic infections in HIV-infected adults and adolescents. Guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, the HIV Medicine Association of the Infectious Diseases Society of America[S/OL]. http://aidsinfo.nih.gov/contentfiles/lvguidelines/adult_oi.pdf.
[10] 卢洪洲. 艾滋病及其相关疾病临床路径[M]. 第2版. 上海:上海科学技术出版社,2015:66-69.
[11] Selwyn PA, Pumerantz AS, Durante A, et al.Clinical predictors of Pneumocystis carinii pneumonia, bacterial pneu-monia and tuberculosis in HIV-infected patients[J].AIDS, 1998, 12(8): 885-893.
[12] Hidalgo A, Falcó V, Mauleón S, et al.Accuracy of high -resolution CT in distinguishing between Pneumocystis carinii pneumonia and non- Pneumocystis carinii pneumonia in AIDS patients[J]. Eur Radiol, 2003, 13(5): 1179-1184.
[13] Roger PM, Vandenbos F, Pugliese P, et al.Persistence of Pneumocystis carinii after effective treatment of P. carinii pneumonia is not related to relapse or survival among patients infected with human immunodeficiency virus[J]. Clin Infect Dis, 1998, 26(2): 509-510.
[14] Safrin S, Finkelstein DM, Feinberg J, et al.Comparison of three regimens for treatment of mild to moderate Pneumocystis carinii pneumonia in patients with AIDS. A double-blind,randomized, trial of oral trimethoprim-sulfamethoxazole, dapsone-trimethoprim, and clindamycin-primaquine. ACTG 108 Study Group[J]. Ann Intern Med, 1996,124(9):792-802.
[15] 中华医学会感染病学分会艾滋病学组, 中华医学会热带病与寄生虫学分会艾滋病学组. HIV合并结核分枝杆菌感染诊治专家共识[J].中华临床感染病杂志,2017,10:81-90.
[16] Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in adults and adolescents living with HIV. Department of Health and Human Services[S/OL]. http://www.aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf.
[17] European AIDS Clinical Society. EACS Guidelines(Version 9.0)[S/OL]. http://www.eacsociety.org/files/guidelines_9.0-english.pdf.
[18] World Health Organization. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach-2nd ed[S/OL]. http://apps.who.int/iris/bitstream/handle/10665/ 208825/9789241549684_eng.pdf;jsessionid=B2870D2288 B92D29DBD1158E8D25E207?sequence=1.
[19] Chen J, Zhang R, Wang J, et al.Interferon-gamma release assays for the diagnosis of active tuberculosis in HIV-infected patients: a systematic review and meta-analysis[J]. PLoS One,2011,6(11):e26827.
[20] Chen J, Sun J, Zhang R, et al.T-SPOT.TB in the diagnosis of active tuberculosis among HIV-infected patients with advanced immunodeficiency[J]. AIDS Res Hum Retroviruses,2011,27(3):289-294.
[21] Pappas PG, Kauffman CA, Andes DR, et al.Clinical practice guideline for the management of candidiasis: 2016 update by the Infectious Diseases Society of America[J]. Clin Infect Dis,2016,62(4):e1-e50.
[22] 刘正印, 王贵强, 朱利平, 等. 隐球菌性脑膜炎诊治专家共识[J].中华内科杂志,2018,57(5):317-323.
[23] World Health Organization. Guidelines for the diagnosis,prevention and management of cryptococcal disease in HIV-infected adults, adolescents and children[S/OL]. http://apps.who. int/iris/bitstream/handle/10665/260399/9789241550277-eng.pdf;jsessionid=222011AFAADA560E12029F954CA43BCD?sequence=1.
[24] Boulware DR, Meya DB, Muzoora C, et al.Timing of antiretroviral therapy after diagnosis of cryptococcal meningitis[J]. N Engl J Med, 2014,370(26):2487-2498.
[25] 中国疾病预防控制中心性病艾滋病预防控制中心. 国家免费艾滋病抗病毒药物治疗手册[M]. 第3版. 北京:人民卫生出版社,2016.
[26] Guidelines for managing advanced HIV disease and rapid initiation of antiretroviral therapy[M]. Geneva: World Health Organization,2017.
[27] 李航, 张福杰, 卢洪洲, 等. HIV感染合并慢性肾脏病患者管理专家共识[J].中国艾滋病性病,2017,23(6):578-581.
[28] 张仁芳, 沈杨, 卢洪洲, 等. AIDS相关性淋巴瘤诊治专家共识[J].中国艾滋病性病,2017,23(8):678-682.
[29] 国家卫生和计划生育委员会办公厅. 国家卫生计生委办公厅关于全面开展预防艾滋病、梅毒和乙肝母婴传播工作的通知[EB/OL].[2018-10-02]. http://www.nhfpc.gov.cn/fys/s3581/201606/4f2123fa955a44afa75a75da2ad35d6e.shtml.
[30] Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission. Recommendations for use of antiretroviral drugs in pregnant HIV-1-infected women for maternal health and interventions to reduce perinatal HIV transmission in the United State[S/OL]. http://aidsinfo.nih.gov/contentfiles/lvguidelines/PerinatalGL.pdf.
[31] World Health Organization. Updated recommendations on first-line and second-line antiretroviral regimens and post-exposure prophylaxis and recommendations on early infant diagnosis of HIV: interim guidance[S/OL]. http://apps.who.int/iris/bitstream/handle/10665/273632/WHO-CDS-HIV-18.18-eng. pdf?ua=1.
[32] U. S.Public Health Service Working Group. Updated U.S.Public Health Service guidelines for the management of occupational exposures to HIV and recommendations for post exposure prophylaxis[S/OL].https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5409a1.htm.
[33] 国家卫生和计划生育委员会办公厅. 国家卫生计生委办公厅关于印发职业暴露感染艾滋病病毒处理程序规定的通知知[EB/OL].[2018-10-02].http://www.nhfpc.gov.cn/jkj/s3585/201507/902caba665ac4d38ade13856d5b376f4.shtml.
[34] 国家卫生和计划生育委员会,人力资源社会保障部,安全监管总局,等.国家卫生计生委等4部门关于印发《职业病分类和目录》的通知[EB/OL]. [2018-10-02].http://www.nhfpc.gov.cn/jkj/s5898b/201312/3abbd667050849d19b3bf6439a48b775.shtml.
[35] Smith CJ, Ryom L, Weber R, et al.Trends in underlying causes of death in people with HIV from 1999 to 2011 (D:A:D): a multicohort collaboration[J]. Lancet, 2014,384(9939):241-248.
[36] Lebrun D, Hentzien M, Cuzin L, et al.Epidemiology of autoimmune and inflammatory diseases in a French nationwide HIV cohort[J]. AIDS, 2017, 31(15): 2159-2166.
[37] Worm SW, De Wit S, Weber R, et al.Diabetes mellitus,preexisting coronary heart disease, and the risk of subsequent coronary heart disease events in patients infected with human immunodeficiency virus: the data collection on adverse events of Anti-HIV drugs (D:A:D Study)[J]. Circulation, 2009,119(6):805-811.
[38] Bower M, Palfreeman A, Alfa-Wali M, et al.British HIV Association guidelines for HIV-associated malignancies 2014[J]. HIV Med, 2014,15:1-92.
[39] Meng X, Yin K, Wang J, et al.Effect of CYP2B6 gene polymorphisms on efavirenz plasma concentrations in Chinese patients with HIV infection[J]. PLoS One, 2015,10(6):e0130583.
[40] Guo F, Cheng X, Hsieh E, et al.Prospective plasma efavirenz concentration assessment in Chinese HIV-infected adults enrolled in a large multicentre study[J]. HIV Med, 2018.doi:10.1111/hiv.12607.[Epub ahead of print].
[41] Carey D, Puls R, Amin J, et al.Efficacy and safety of efavirenz 400 mg daily versus 600 mg daily: 96-week data from the randomised, double-blind, placebo-controlled, non-inferiority ENCORE1 study[J]. Lancet Infect Dis, 2015,15(7):793-802.
[42] Guaraldi G, Palella FJ.Clinical implications of aging with HIV infection: perspectives and the future medical care agenda[J]. AIDS, 2017,31(Suppl 2):S129-S135.