Physician Day 丨 Yin Ke: Discovery is treatment, in recent years, AIDS mortality has declined significantly

Cover Journalist Ning Zhi

August 19 is the Fifth Chinese Physician's Day. There is such a group of doctors around us, where everyone invisible, firmly adhere to the safety defense line of infectious diseases, and silently dedicate in their posts.

In this special day, we interviewed Yin Ke, deputy chief physician of the infection of the infection of the Chengdu Public Health Clinical Medical Center. He told us a new change in AIDS in recent years.

Yin Ke

【Change 1】

Previous: Drag to the advanced period before the clinic

Now: As soon as you find out AIDS, it is treated immediately

Yin Ke pointed out that the number of deaths of AIDS patients decreased by the increase in the total number of AIDS patients in the year year by year.

Many AIDS patients who came to the doctor in the past were as soon as a consultation with late AIDS, and usually merged with various serious opportunity infections, such as meningitis, severe pneumonia, sepsis, etc., which were difficult to treat. Essence Yin Ke said: "As long as you find HIV (HIV) now, the doctor will suggest that the patient will be treated with antiviral treatment immediately."

"Why doctors suggest to find that it is treated? If antiviral treatment is performed in time, HIV replication can be significantly reduced, the patient's immune function is improved, and the occurrence of serious opportunistic infections can be avoided." Yin Ke said.

He said that the current HIV treatment has entered the era of "three driving carriages", namely: free medicine+medical insurance medicine+self -funded medicine, each patient can choose according to his actual situation. The most currently taken in the country's free drugs is "TLE (TLE)". Secondly, many self -funded drugs are included in the medical insurance reimbursement catalog, which can significantly reduce the economic burden of using this type of drug patients.

【Changes 2】

Previous: viral suppression must be more than half a year to consider conception

Now: You can also conceive naturally under special circumstances

Maternal and baby communication is an important way to infect HIV. Whether it is a Shuangyang family or a Shanyang family, it may involve fertility problems. How to block maternal and infants and prevent children from infection with HIV?

Yin Ke said that the HIV -positive side receives antiviral treatment and the virus has reached continuous suppression, which is the key to HIV Shanyang family pregnancy. In addition, in order to improve the power of conception, it is very important to accurately calculate the ovulation period and can seek the help of obstetrics and gynecologists.

Of course, there are some specific situations. Yin Ke introduced that when HIV -positive men try to conceive naturally without reaching virus suppression and try to conceive naturally, HIV -negative women should continue to take TDF/FTC for exposure prevention from 20 days before ovulation. In the case of natural pregnancy, HIV negative prescriptions must perform HIV antibody screening to exclude HIV spread among spouses.

In the end, Yin Ke reminded that those who prepare for pregnancy in HIV patients need to conduct ART drug intervention+safe delivery+postpartum feeding guidance under the guidance of a professional doctor.

【Change III】

Previous: take HIV blocking drugs after exposure

Now: can also take HIV blocking drugs before exposure

After the HIV exposure of the Chengdu Public Health Center, more and more people have learned about the knowledge and concepts of AIDS prevention.

"In the past few years, the patients that we met after the prevention clinic were mainly consulted after the exposure of the outpatient clinic. PEP refers to the high -risk act. , Thereby blocking a way of treatment of HIV spread. "Yin Ke said that this situation has changed to a certain amount of situation.

In HIV drug prevention clinics, more and more people are consulting pre -exposure prevention (Prep). Yin Ke said that there are two methods now. The first is called "2-1-1" therapy. For special high-risk people, take two TDF/FTC 2-24 hours before high-risk behavior. Take 1 TDF/FTC each hour and 48 hours, which has a good effect of preventing HIV. The second is called "Daily Medicine Plan": Oral TDF/FTC is taken every 24 hours. It is suitable for various high -risk people and take it once a day. "Both schemes only apply to patients with HIV negatives, age over 18 years old, and kidney EGFR greater than 60," he said.

Yin Ke also emphasized that he must go to a regular medical institution to seek correct consultation and help. If the medication is irregular or takes foods with drug interactions, it may cause blocking failure.

【Character extension】

"Being a person is the first, and the medicine is the most important", "I like the patient the most likely to call me Dr. Yin, which makes me feel the responsibility of the patient, and it is also the patient's recognition and affirmation of me." In the past 20 years, he has been working in the HIV Department of the Chengdu Public Health Center. He believes that the biggest difference between AIDS and other departments is to communicate with doctors and patients.

Yin Ke said, "In addition to the treatment, doctors need to communicate with patients and take the initiative to care for patients. Caring is the most significant business card in our department. Because facing some special patients, medical staff in our department must be more careful. , More patient, have more care and enthusiasm for patients. "

He said that because patients with AIDS are generally fragile, and each patient has different characteristics. Treatment requires individualization. One disease may often need to be hospitalized repeatedly.Must be a careful observers, patient listeners and keen conversators, not only rely on professional medical technology to reduce the pain of patients, but also requires the psychological construction of patients to let them face life bravely and actively treat them.Give up lightly and actively face every day.

- END -