217.4 📌 章末速蚘

  • Universal ART start all HIV+ regardless of CD4 (DHHS, WHO)
  • First-line (DHHS 2024):
    • Biktarvy (BIC/TAF/FTC) most adults
    • DTG + TDF/FTC pregnancy
    • Dovato (DTG/3TC) 2-drug alt
    • Cabenuva (CAB/RPV) LA injectable for suppressed
  • InSTI-based first-line preferred
  • Lenacapavir capsid inhibitor every 6 mo
  • PrEP: Truvada/Descovy daily, Apretude IM every 2 mo, Lenacapavir SC every 6 mo (2025+)
  • PEP: within 72 hr, 3-drug × 28 days
  • Resistance testing at diagnosis + virologic failure
  • Drug interactions critical: InSTI + cations; PI/cobi = CYP3A4 inhibitor; rifampin incompatible most PIs
  • IRIS: low CD4 + OI; continue ART + treat OI + steroid for severe
  • Pregnancy: DTG + TDF/FTC preferred; < 2% vertical with PMTCT
  • HBV co-infection: HBV-active ART (TDF/TAF + FTC/3TC)
  • U=U achievable in well-managed
  • 2030 95-95-95 target UNAIDS
  • REPRIEVE 2024: pitavastatin reduces MACE in HIV+
  • Berlin/London/DÃŒsseldorf cure cases — proof of concept (CCR5Δ32 HSCT)
  • 公費 ART + PrEP Taiwan + many countries