我国艾滋病病毒感染孕产妇及所生儿童应用抗反转录病毒药物的状况及变化趋势

目的了解我国部分艾滋病(AIDS)高流行地区,艾滋病感染孕产妇及所生儿童应用抗反转录病毒(ARV)药物状况及变化趋势。方法 2005年1月至2008年12月,在艾滋病病毒(HIV)感染相对高发的5省23个市(县、区),对1 414名HIV-1感染孕产妇及所生儿童进行问卷调查及随访管理,收集研究对象所应用ARV药物种类、方案等一系列信息。结果1 414名研究对象中,2005-2008年各年分别有77.13%、77.73%、78.26%和84.20%的HIV感染孕产妇应用了ARV药物,并呈现逐年递增的趋势(χ2=5.90,P=0.01)。艾滋病感染产妇三联ARV药物应用比例呈现逐年上升趋势,而单一NVP应用比例逐年下降(χ2=237.17,P<0.000 1;χ2=276.49,P<0.000 1)。预防性及治疗性三联药物方案应用比例仍不足40%和15%,上升幅度有限(χ2=45.79,P<0.0001;χ2=151.96,P<0.0001)。结论继续扩大艾滋病感染孕产妇及所生儿童应用高效抗反转录病毒治疗(HAART)覆盖面,提高ARV药物的可及性,尤其是三联ARV药物方案的应用。

The trends of using antiretroviral drugs among HIV infected pregnant women and their Children in China

Objective To describe trends of using antiretroviral drugs for PMTCT among HIV infected pregnant women and their children.Methods A prospective observational cohort study was conducted from 2005 to 2008 in 23 counties/ districts of 5 provinces with high HIV prevalence among 1 414 HIV infected mothers and their infants.The information on demographic characteristics of the subjects and the regimens of antiretroviral(ARV) drugs was collected.Results From 2005 to 2008,77.13%,77.73%,78.26% and 84.20% of the HIV infected pregnant women received ARV drugs in the respective years.The proportion of women receiving ARV drugs increased year by year(χ2=5.90,P=0.01).The use of combination of ARV drugs was also increasing year by year,and single-dose ARV drugs were reducing in use over time(χ2=237.17,P<0.000 1;χ2=276.49,P<0.000 1).The proportion of HIV positive pregnant women who received triple ARV prophylaxis and highly active anti-retroviral therapy(HAART) was still below 40% and 15%,with limited rise over time(χ2=237.17,P<0.000 1;χ2=276.49,P<0.000 1).Conclusion The coverage of antiretroviral drugs should be expanded;the relevant health departments should improve the availability of antiretroviral drugs,especially for triple ARV prophylaxis and highly active anti-retroviral therapy.