首页 中华传染病杂志 2024年42卷05期 中国艾滋病诊疗指南(2024版)
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中国艾滋病诊疗指南(2024版)
中华医学会感染病学分会艾滋病学组 
中国疾病预防控制中心
作者及单位信息
·
DOI： 10.3760/cma.j.cn311365-20240328-00081
Chinese guidelines for diagnosis and treatment of human immunodeficiency virus infection/acquired immunodeficiency syndrome (2024 edition)
Acquired Immunodeficiency Syndrome Professional Group, Society of Infectious Diseases, Chinese Medical Association;
Chinese Center for Disease Control and Prevention
Li Taisheng
Authors Info & Affiliations
Acquired Immunodeficiency Syndrome Professional Group, Society of Infectious Diseases, Chinese Medical Association;
Chinese Center for Disease Control and Prevention
Li Taisheng
Department of Infectious Diseases, Beijing Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730
·
DOI： 10.3760/cma.j.cn311365-20240328-00081
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摘要
中华医学会感染病学分会艾滋病学组于2005年制订了我国《艾滋病诊疗指南》(以下简称《指南》), 2024版《指南》是在2021年第5版《指南》的基础上参照国内外最新研究进展修订而成。新版《指南》重点对抗病毒治疗、全程管理、机会性感染、人类免疫缺陷病毒(HIV)合并肿瘤、HIV感染的预防与干预等内容进行了更新，并新增"艾滋病免疫功能重建不全"这部分内容，首次提出了"艾滋病脆弱人群"的概念，增加了诊治推荐意见及其推荐证据和推荐强度。新版《指南》包括流行病学、病原学特征、实验室检测、发病机制、临床表现与分期、诊断标准、常见机会性感染、抗病毒治疗、免疫重建炎症综合征、免疫功能重建不全、艾滋病相关肿瘤、HIV母婴传播阻断及单阳家庭生育、HIV暴露前后预防与阻断、HIV感染的全程管理等14个方面的内容。本《指南》旨在帮助临床医师在艾滋病诊治和管理中合理决策，《指南》也将根据国内外的研究进展定期进行修订与更新。
获得性免疫缺陷综合征;人类免疫缺陷病毒;诊断;治疗;指南
引用本文
中华医学会感染病学分会艾滋病学组,中国疾病预防控制中心. 中国艾滋病诊疗指南(2024版)[J]. 中华传染病杂志,2024,42(05)：257-284.
DOI:10.3760/cma.j.cn311365-20240328-00081PERMISSIONS
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艾滋病，即获得性免疫缺陷综合征(acquired immunodeficiency syndrome，AIDS)，其病原体为人类免疫缺陷病毒(human immunodeficiency virus，HIV)，亦称艾滋病病毒。AIDS是影响公众健康的重要公共卫生问题之一。中华医学会感染病学分会艾滋病学组牵头，于2005年制订了我国《艾滋病诊疗指南》(以下简称《指南》)第1版，2011年、2015年、2018年和2021年分别进行了更新
[
1
]。
中华医学会感染病学分会艾滋病学组定期对《指南》进行更新修订。2024版《指南》是在2021版《指南》的基础上，结合国外最新指南和相关研究结果更新修订而成。学组委员首先对新版《指南》更新的主要内容进行讨论，决定重点对AIDS抗病毒治疗、AIDS全程管理、机会性感染、HIV合并肿瘤、HIV感染的预防和干预等内容进行更新，并增加"免疫功能重建不全"这部分内容，提出"AIDS脆弱人群"的概念并增加其临床管理的内容，增加诊治推荐意见及其推荐证据和推荐强度。编写组专家对新版《指南》中的关键问题和更新内容进行系统文献检索，纳入指南、共识、系统评价和荟萃分析、随机对照试验、非随机对照试验队列研究和病例对照研究等类型的证据。编写组收集、整理、归纳、检索文献，形成指南的更新内容和推荐意见。学组委员对新版《指南》修改的内容、49条推荐意见及其推荐证据和推荐强度进行充分讨论后形成了2024版《指南》的最终稿。本《指南》旨在帮助临床医师在AIDS诊治和管理中合理决策，而非强制性标准，也不可能涵盖AIDS诊治中的所有问题。学组将根据国内外研究进展定期对《指南》进行修订和更新。
本《指南》中的推荐意见基于科学研究证据和专家意见，每条推荐意见后面的大写字母(A、B或C)和阿拉伯数字(1或2)分别表示支持该推荐意见的证据质量和推荐强度，见
表1
[根据推荐等级的评估、制订与评价(grading of recommendations assessment, development, and evaluation，GRADE)分级修订]。
| 分级 | 具体描述 |
|---|---|
| 证据级别 | |
| A(高质量) | 进一步研究不大可能改变对该评估结果的信心 |
| B(中等质量) | 进一步研究有可能使我们对该评估结果的信心产生重要影响 |
| C(低质量) | 进一步研究很有可能影响该评估结果，且该评估结果很可能改变 |
| 推荐等级 | |
| 1(强推荐) | 充分考虑到了证据的质量，患者可能的预防、诊断和治疗成本而最终得出的推荐意见 |
| 2(弱推荐) | 证据价值参差不齐，推荐意见存在不确定性，或推荐的意见可能会有较差的成本疗效比等，更倾向于较低等级的推荐 |
展开表格
推荐意见的证据分级与推荐强度分级标准
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备注信息
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李太生，中国医学科学院 北京协和医学院 北京协和医院感染内科，北京 100730 Email：
tendef.3ab62hstil
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中国医学科学院医学与健康科技创新工程项目 (2021-I2M-1-037)
北京协和医院中央高水平医院临研专项 (2022-PUMCH-D-008)
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