欧洲HIV检测白皮书和检测需要延长到6个月的原因！
本帖最后由 fjgoodluck 于 2010-8-29 10:51 编辑It is recommended that patients have a baseline HIV test done at presentation and, if
necessary, repeated at 3 months from the time of high risk exposure. (IIb, B)
? Individuals with a high risk exposure to HIV should not be fully reassured until at least 3
months have passed during which they remain seronegative.37 (IV C)
? Recalling individuals for a follow-up longer than 3 months should be considered only
exceptionally e.g. if post exposure prophylaxis was given for occupational exposures,
where the tested subject has an substantially impaired ability to develop antibodies and
where there is microbiologically proven simultaneous infection with another viral
pathogen such as human cytomegalovirus or hepatitis C virus.3,38,39 (IV, C)
? If a patient presents with clinical symptoms suggestive of HIV infection or AIDS and the
HIV screening tests are repeatedly negative, then referral of the specimen to a
specialised laboratory for analysis using alternative screening tests or molecular tests to
exclude uncommon HIV strains is recommended
建议是3个月复查
有人类巨细胞病毒感染或者丙肝感染的话要延长至三个月后
职业暴露需要测三个月更长（可能是因为服用阻断药物导致机体产生抗体能力减弱）
对于有暗示感染HIV的临床症状而抗体检测为阴的患者，讲标本送至特别实验室，利用不同的测试方法或者分子量测试来排除非正常HIV感染的可能性
曾经有过丙肝艾滋合并感染，一年后才查处抗体的案例恐友的恐慌
对此专家拿来说事的典型案例hiv hcv合并感染者症状阴性然后来看一下 专家对丙肝合并感染艾滋的观点
healing well网站id为apple92681的医生的观点
This is a complicated answer and I apologize ahead of time:There are VERY FEW times when I would recommend waiting for 3 months to get an HIV antibody test, but in a case that may alsoinvolve Hepatitis C-Virus, I certainly do! Why?Well, for one, having Hep C may lower the immune system's ability to quickly produce antibodies to HIV because it would be overwhelmed already in trying to produce them for Hep C. So, while most people with otherwise uninhibited immune systems would show positive on a 6-week test, a person whose immune system is already bogged down with Hep C should wait out for three months -- just to be 100% certain!
So, to my knowledge, it would be safe to test for both at three months. Where I work, a Hep C antibody test is done by the County of Los Angeles and we only recommend it (along with an HIV test) if the person in question has admitted to sharing drug equipment.
A person who has Hep C might take an HIV-ELISA (antibody test) and show up "positive", which would then have to be confirmed by a Western Blot test. If the person is only infected with Hep C, not HIV, then the Western Blot would rule that out.
So, all in all, if you are concerned about a possible co-infection, then test for both at 3 months.
P.S. -- HIV/Hep C co-infection is rarely seen outside of the population that abuses drugs. This is because people who shareneedles and may be Hep C carriers, might also be HIV-positive due to their habits.
If someone re-uses a needle hours later, the HIV virus will have died due to its fragility when exposed to air. However, Hep C, being a sturdier virus, can live longer and therefor infect.
如果合并感染了hiv和hcv会使得免疫力为了对付而肝炎不堪重负 延缓了hiv抗体产生 那么建议在3月时检查排除 hiv hcv合并感染多见于公用针头吸毒者
thebody网站DR. BABARA
The CDC recommends that health care workers who are exposed to a HIV/HCV coinfected patients get HIV testing at baseline, six, and 12 weeks after exposure. However, if - and only if - the healthcare worker becomes ill with ACUTE HEPATITIS C INFECTION - THEN AND ONLY THEN - is additional testing for HIV recommended at 12 months. If the healthcare worker does not get acute hepatitis C infection, testing is complete for both infections at six months.
医护工作者在接触HIV/HCV合并感染的病人，并发生职业暴露之后，在接触后当时，6周，12周进行HIV抗体检测只有且仅有一种情况--当医护工作者因为感染而发展为急性丙肝病人的时候，才需要推荐在12个月后进行额外的HIV抗体测试
何大一教授
I'm not sure if we would have data to speak to that. And I haven't read anything that's convincing to me that Hepatitis C slows down creation of HIV antibodies…what's called "seroconversion."
我不能肯定因为没有数据能说明这点 我也没有看到任何可靠的数据说明hcv会减缓hiv抗体的产生
原深圳市疾病预防控制中心今深圳市慢性病医院主任医师：冯铁建教授
因为这是一个个案，所以说，普通的恐友，只要3个月阴，就可以放心了，退一步来说，你实在不放心，也可以检测到6个月，但那个只是为了你的放心，而不是说窗口期要延长到六个月
时医生
你看的那份资料，估计我也看过，目前没有很确切的资料研究表明丙肝会影响抗体的产生，如果是因为某个病人的确因为丙肝延长窗口期，那并不排除病人有另外的原因，比如复高，或者服用了阻断药物，但那个只是个案而已。
05年的全国丙肝高峰论坛暨HIV论坛，顶尖的专家都达成一致意见 丙肝不会影响窗口期
参加本次会议的世界卫生组织官员有WHO艾滋病司司长：Jim Yong Kim（美国）、WHO助理总干事：刘培龙（中国）、WHO总部高级技术官员：Peter Graaff（荷兰）、WHO驻华代表处高级顾问：Connie Osborne（赞比亚）、 WHO驻华代表处项目官员：陈红（中国）。WHO总部Donald Suther Land教授。与会的国内知名专家有：中华医学会感染病学会名誉主任委员、北京大学第一人民医院斯崇文教授，中华医学会感染病分会主任委员、上海复旦大学华山医院翁心华教授，中华医学会感染病分会副主任委员、北京地坛医院成军教授，中华医学会感染病分会常委兼学术秘书、上海长征医院缪晓辉教授，中华医学会感染病分会常委、北京协和医院李太生教授，中国医学科学院、北京协和医科大学艾滋病研究中心曹韵贞教授，中华医学会感染病学分会艾滋病和丙型病毒性肝炎学组副组长、北京大学第一人民医院徐小元教授，北京地坛医院郎振为教授，上海市公共卫生中心卢洪洲主任，上海复旦大 学华山医院潘孝彰教授，广州市第八人民医院唐小平院长，首都医科大学附属佑安医院吴昊教授，上海市公共卫生中心孙洪清教授，中国人民解放军第302医院王福生教授等
第三部分 丙肝于性
healing well网站id为TalktomeHIV的版主
Which Hepatitis C is really not a risk sexually. B is, though even if infected, 90-95 percent of adults will clear it naturally in time.
性行为没有丙肝风险 乙肝有风险 但即使接触到乙肝病毒 90%到95%的成年人能及时消灭它（指的是性行为 接触病毒量小的情况下）
美国cdc
The hepatitis C virus (HCV) is transmitted primarily by large or repeated direct percutaneous (i.e., passage through the skin by puncture) exposures to contaminated blood. Therefore, coinfection with HIV and HCV is common (50%-90%) among HIV-infected injection drug users (IDUs). Coinfection is also common among persons with hemophilia who received clotting factor concentrates before concentrates were effectively treated to inactivate both viruses (i.e., products made before 1987). The risk for acquiring infection through perinatal or sexual exposures is much lower for HCV than for HIV. For persons infected with HIV through sexual exposure (e.g., male-to-male sexual activity), coinfection with HCV is no more common than among similarly aged adults in the general population (3%-5%).
丙肝主要是通过破损(皮肤的伤口通道)接触感染血液造成的.所以,合并感染在共用针头人群中很普遍(50%-90%).合并感染也会在同时获得两种病毒的血液制品在血友病患者中传播.在性接触和围产期的感染远远低于HIV的感染率 通过性行为感染艾滋的人中 感染hcv的比率与普通人群没有什么差别(3%-5%)
HCV Sexual Transmission Revisited: A Look at the Latest Research
Liz Highleyman
Most studies indicate that sexual transmission of HCV is very uncommon among long-term, monogamous, HIV negative heterosexual couples, with rates in the range of 0%-3%. As reported in the May 2004 American Journal of Gastroenterology, for example, Carmen Vandelli and colleagues followed 895 HCV negative individuals who had monogamous sexual relationships with HCV positive partners. Over 10 years of follow-up, just three new HCV infections occurred, for an incidence rate of 0.37 per 1,000 person-years (PY). The authors concluded that “the risk of sexual transmission of HCV within heterosexual monogamous couples is extremely low or even null.” Likewise, V. Tahan and colleagues reported in the April 2005 American Journal of Gastroenterology that none of 216 HCV negative individuals with opposite-sex HCV positive spouses seroconverted during an average follow-up period of about three years.
夫妻间hiv传播不常见在0~3%之间（长期的夫妻性生活 不是指一次性的概率）
H. Hunter Handsfield这位相信很多恐友认识 medhelp上很知名的医生
There is no controversy.HCV may rarely be transmitted sexually, but it is uncommon.The frequency of HCV in the regular sex partners of persons with hepatitis C is no higher, on average, than the frequency in the general population--unless those sex partners also regularly share blood, e.g. through injection drug use with shared equipment.The uncommon cases of sexual transmission probably do involve blood, e.g. traumatic anal sex.There is no evidence that vaginal intercourse transmits HCV.
不存在争论。HCV有可能通过性传播，但是不普遍。丙肝患者的固定性伴侣的丙肝患病率平均看来并没有高于普通人群，除非这些性伴侣与丙肝患者经常存在血液交换，例如共用注射器注射毒品。少见的通过性传播的病例可能与血液交换有关，例如外伤性的肛交。并没有证据表明阴道交会传染丙肝。
中国某地区对456名性服务人员调查
乙肝 33人 丙肝 4人 hiv 1人 梅毒 48人 hsv 148人
有40例同时感染2种及以上的病例 未发现同时感染丙肝及艾滋
肝炎窗口期
The body网站Dr. McGovern
In general, patients with acute hepatitis C develop antibodies in about 8 weeks. Yes seroconversion can take longer, up to 12 weeks and very uncommonly as long as six months. However, the last scenario is extremely rare and I think is overemphasiz
大部分在8周内转阳 有时会12周 非常少见的有6个月，我认为这种情况太少见但被过分强调了
总结
1 个别窗口期超常案例没有代表性
2 专家的观点1 不会影响窗口期 2 有一定影响 但3个月足够检测出 3 只有发展为急性丙肝病人 需要延长窗口期 否则3个月
3 精液与阴道分泌物中丙肝病毒含量很低 不易通过性行为传播
一次无保护性jiao感染艾滋概率在1/500至1/1000 一次无保护性jiao感染丙肝概率小于艾滋 所以一次性jiao同时感染艾滋和丙肝几乎不可能
http://www.thebody.com/h/CMIA-method-for-HIV-window-period.html 不知道你们这些东西都是那找出来，说的就和真的一样。别拿这些东西来哄人好不好。有风险就检查才是硬道理找那么多理由做什么呢！不管风险有多大就是有风险。 就是告诉你们！3个月阴就安全了！！6个月那种是极个别的！ 那乙肝影响窗口期吗？？？？？？？？ 首先要看看三个月复查的原因是什么，对于楼主的行为，本身就没有风险，还要谈三个月六个月的干什么？我说过在正常状态下的口交是没有感染的可能的，除了极个别的案例，情况极其特殊，对于普通人是不可能有的。所以楼主我觉得你检查都是多余的。 你怎么知道我的行为？ 5# 不明白 作为cdc来说，他必须把所有情况都包含在内，才能做到尽职尽责。但是对于绝大多数普通人，这些是没有意义的。因为他们都不是非正常人群。 回复 6# fjgoodluck
搜你的帖子就有了 你怎么很反感我么 我是45天阴 95天阴了！！心理还是隐隐约约的恐，只是不严重了！！天天没事就想搜索HIV的资料！！不清楚自己的身体是否属于正常标准，我只打过乙肝疫苗 和甲肝疫苗！不清楚丙肝的，所以担心啊！ 8# 不明白 。。。
哎 被搞晕了！
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