216.4 📌 章末速蚘

  • HIV: retrovirus, ssRNA, lentivirus
  • HIV-1 (worldwide main) + HIV-2 (W Africa, NNRTI-R, slower)
  • Receptor: CD4 + CCR5 or CXCR4
  • 39M globally; 1.3M new + 630K deaths/yr (2023 UNAIDS)
  • Stages: acute → clinical latency → AIDS (CD4 < 200 or AIDS-defining)
  • Acute Retroviral Syndrome: mono-like 2-4 wk post-exposure (~ 50%)
  • U=U: undetectable < 200 copies/mL = no sexual transmission (PARTNER + PARTNER2 + Opposites Attract)
  • Diagnosis: 4th-gen combo (Ab + p24) → confirmatory HIV-1/HIV-2 differentiation + HIV RNA PCR for acute / pediatric
  • Universal screening all 13-64 yr at least once
  • Functional cure cases: Berlin/London/DÃŒsseldorf/NYC patients (CCR5Δ32/Δ32 HSCT)
  • Latent reservoir = cure obstacle (resting memory CD4+, macrophages, microglia)
  • PMTCT: maternal ART + infant prophylaxis + formula feeding → < 2% vertical
  • 95-95-95 by 2030 UNAIDS target