2013-2015年广东省127例预防HIV母婴传播综合干预效果北大核心CSCD

目的了解广东省以人群为基础的预防艾滋病母婴传播综合干预的效果,为进一步做好预防母婴传播工作提供依据。方法在国家预防艾滋病母婴传播信息系统中导出并整理了广东省2013-2015年127例艾滋病病毒（HIV）感染孕产妇的监测随访资料。采用SPSS 18.0统计软件进行描述性分析。结果2013-2015年127例HIV感染孕产妇,分娩婴儿135人（包含6例双胎,1例3胎）,其中感染HIV婴儿6例,母婴传播率4.44%。孕期接受HIV检测的占69.29%（88/127）;使用抗病毒药物治疗的孕产妇占74.80%（95/127）,其中孕期（36周前）服用药物的占91.58%（87/95）,产时和产后服药的占8.42%（8/95）,两者的母婴传播率分别为2.11%、12.50%,差异有统计学意义（χ~2=4.502,P〈0.05）。HIV感染孕产妇所生婴儿使用抗病毒药物的占85.93%（116/135）,未服药的占14.07%（19/135）,两者的母婴传播率分别为2.59%、15.79%,差异有统计学意义（χ~2=5.178,P〈0.05）;采用人工喂养方式的婴儿占92.59%（125/135）,未采用人工喂养的占7.41%（10/135）,两者的母婴传播率分别为3.20%、20.00%,差异有统计学意义（χ~2=4.634,P〈0.05）。结论通过孕期尽早检测HIV,尽早对HIV感染孕产妇及所娩婴儿规范使用抗病毒药物,加强对孕产妇及所娩婴儿的监测随访指导,提倡人工喂养等综合干预措施,能有效降低HIV母婴传播。     

2010-2020年乌鲁木齐市HIV感染孕产妇母婴传播情况及影响因素分析

目的 分析乌鲁木齐市HIV感染孕产妇所生婴儿母婴传播情况及母婴传播的影响因素。方法 在国家“预防艾滋病、梅毒和乙肝母婴传播信息管理系统”中收集2010年1月1日至2020年12月31日乌鲁木齐市HIV感染孕产妇及所生婴儿的相关信息,分析HIV感染孕产妇一般人口学特征、HIV感染时期、用药方式、用药时间、孕期异常情况及暴露婴幼儿一般情况等因素,比较不同组间母婴传播率差异,并采用Logistic回归模型分析其相关影响因素。结果 共纳入412例HIV感染孕产妇,HIV感染孕产妇所生婴儿发生母婴传播14例（3.40%）,其中2010-2015年母婴传播率为3.98%,2016-2020年母婴传播率为2.69%。HIV感染孕产妇应用抗病毒药物328例（79.61%）,未应用抗病毒药物84例（20.39%）,其中联合用药317例（76.94%）、单一用药11例（2.67%）,孕期用药273例（66.26%）、产时用药55例（13.35%）;孕期发生异常情况121例（29.37%）、孕期未发生异常情况291例（70.63%）。Logistic回归分析结果显示,HIV感染孕产妇孕期开始用药（OR=0....     

2016-2020年海南省HIV感染孕产妇预防母婴传播措施利用状况分析

目的 了解海南省2016-2020年HIV感染孕产妇的特征及其接受预防艾滋病母婴传播（PMTCT）等孕产期保健服务情况,为指导海南省消除HIV母婴传播提供科学依据。方法 利用“国家预防艾滋病、梅毒和乙肝母婴传播管理信息系统”中导出的2016-2020年海南省报告的“预防HIV母婴传播综合服务”数据进行分析,将HIV感染的孕产妇分为既往感染组和本次妊娠确诊组,分析两组孕产妇特征及预防母婴传播服务利用情况。结果 2016-2020年海南省孕产妇HIV抗体检测率为99.65%(630 050/632 262),检出HIV感染孕产妇101例,阳性率为1.60/万,产妇抗病毒用药率83.10%(59/71),婴儿抗病毒用药率92.96%(66/71)。既往感染组孕产妇56例,HIV暴露儿童43例;首次确诊组孕产妇45例,HIV暴露儿童28例。既往感染组孕产妇文化程度高于本次妊娠确诊组,并在初检孕周、接受PMTCT服务时期等方面优于本次妊娠确诊组,差异有统计学意义;本次妊娠确诊组孕产妇所生婴儿HIV早期诊断结果阳性比例（10.71%,3/28）高于既往感染组（2.33%,1/43）。结论 海南省孕...     

2017—2021年乌鲁木齐市预防艾滋病、梅毒和乙型肝炎母婴传播效果分析

目的 分析2017—2021年乌鲁木齐市预防艾滋病、梅毒和乙型肝炎（简称乙肝）母婴传播工作相关指标,为本市推进消除母婴传播工作提供工作思路和参考。方法 从国家预防艾滋病、梅毒和乙肝母婴传播信息管理系统中收集乌鲁木齐市孕产妇艾滋病、梅毒和乙肝的检测、感染、治疗和暴露儿童干预情况,用趋势卡方检验分析各年度间相关指标的变化趋势。结果 2017—2021年乌鲁木齐市累计检测孕产妇175 858人,艾滋病、梅毒和乙肝总体检测率分别为99.94%、99.97%和99.97%,总体检出阳性率分别为0.12%、0.24%和4.08%,艾滋病（趋势χ2=6.535）和乙肝（趋势χ2=10.607）检出阳性率均呈下降趋势（P<0.05）,梅毒检出阳性率差异无统计学意义（趋势χ2=0.037,P>0.05）。2017—2021年艾滋病、梅毒阳性孕产妇用药率分别为84.18%和65.76%,梅毒阳性孕产妇用药率呈上升趋势（趋势χ2=16.103,P<0.05）,艾滋病阳性孕产妇用药率差异无统计学意义（趋势χ2=0.703,P>0.05）。2017—2021年艾滋病、梅毒阳性孕产妇所生儿童预防用药率为96.97%和80.20%,乙肝阳性孕产妇所生儿童免疫球蛋白注射率为99.83%,艾滋病（趋势χ2=0.100）和梅毒（趋势χ2=3.293）暴露儿童预防用药率不同年度差异无统计学意义（P>0.05）,乙肝暴露儿童免疫球蛋白接种率连续5年>99.00%。结论 乌鲁木齐市预防艾滋病、梅毒和乙肝母婴传播工作取得一定成效,三病检测率保持在较高水平,孕期检测率逐渐提高,艾滋病、乙肝检出阳性率逐渐降低,暴露儿童的干预服务不断完善;仍需继续加强疾病防控,降低梅毒孕期检出阳性率,提高艾滋病、梅毒感染孕产妇的治疗率,并应加强干预措施,落实“逢孕必检,逢阳必治”的工作原则,推进乌鲁木齐市消除母婴传播的目标。     

2015—2021年桂林市孕产妇艾滋病流行病学特征及消除母婴传播工作成效评估

目的 了解2015—2021年广西壮族自治区桂林市孕产妇艾滋病(HIV/AIDS)流行病学特征及消除母婴传播工作进展，为推进消除艾滋病病毒母婴传播工作提供理论依据。方法 通过预防艾滋病、梅毒和乙肝母婴传播管理信息系统，收集2015—2021年桂林市报告孕产妇病例信息开展回顾性分析。结果 检测孕产妇HIV抗体402 559人、抗体检测率99.99%,HIV感染率5.34/万；215例HIV感染孕产妇平均年龄(31.13±5.17)岁，汉族占70.23%(151/215)，初中文化占67.91%(146/215)，农民占52.09%(112/215)。孕期保健时确诊HIV感染102例、占47.44%，性传播是主要传播途径。2015—2021年HIV感染孕产妇用药202例、用药率93.95%，各年用药率呈上升趋势(趋势χ²=62.123,P<0.05)，感染孕产妇所生儿童预防性用药212人，用药率98.60%，呈逐年上升趋势(趋势χ²=21.741,P<0.05)。2021年艾滋病母婴传播率为0.00%，新发感染0例；2019—2021...     

感染HIV孕产妇及其所生婴幼儿应用抗反转录病毒药物的时间分布及变化趋势

目的了解中国部分艾滋病高流行地区,感染艾滋病病毒（HIV）的孕产妇及其所生的0-18月龄婴幼儿应用抗反转录病毒（ARV）药物的时间分布及变化趋势。方法于2005年1月至2008年12月,对23个市/县/区的医疗保健机构发现的1 414名感染HIV的孕产妇及其所生婴幼儿,进行问卷调查及随访管理,收集他们所应用的ARV药物的方案、时间、持续时间、规范用药等信息。结果 2005-2008年,感染HIV的孕产妇,各年孕期用药的比例分别为10.27%、22.47%、40.85%和67.56%,差异有统计学意义（cmhχ2=232.06,P〈0.000 1）,用药比例上升幅度为57.29%;感染HIV孕产妇孕早、中、晚期用药比例从2005年的11.11%上升至2008年的25.00%,差异有统计学意义（cmhχ2=6.94,P=0.008 4）。2005-2008年,感染HIV孕产妇规范服用ARV药物的比例分别为95.82%（252/263）、92.70%（165/178）、85.62%（262/306）和73.19%（273/373）,差异有统计学意义（cmhχ2=68.43,P〈0.000 1）。结论尽管感染HIV的孕产妇孕期用药的比例有所上升,但其规范应用ARV药物的状况仍不理想。因此,应在保证早期用药的同时,加强感染HIV孕产妇长疗程用药的依从性和规范性。     

广西945例HIV阳性孕产妇母婴传播综合干预措施利用情况

目的了解广西艾滋病病毒(HIV)感染孕产妇母婴传播综合干预措施的利用情况,为制定HIV阳性孕产妇综合管理策略提供依据。方法对2011年1月至2014年12月,945例HIV感染孕产妇及其所生满18月龄儿童的信息,进行回顾性分析。结果 88.47%(836/945)HIV感染孕产妇应用抗病毒治疗,其中孕期用药率为78.73%(744/945)。在孕期用药的感染孕产妇中,25.94%(193/744)为孕14周前开始用药,52.69%(392/744)为孕14-28周开始用药。在分娩方式的选择上,62.22%(588/945)为阴道分娩,22.43%(212/945)为择期剖宫产,15.34%(145/945)为急诊剖宫产。945例HIV阳性产妇所生儿童中,93.86%(887/945)应用抗病毒治疗,0.32%(3/945)的婴儿1月龄时曾接受过母乳喂养,暴露儿童HIV抗体检测阳性30人,阴性915人。孕产妇是否应用抗病毒治疗(χ2=21.340,P0.01),孕产妇选择不同的分娩方式(χ2=6.497,P0.05),儿童是否应用预防性抗病毒治疗,均与儿童最终的感染状况有关(χ2=10.335,P0.01)。多因素分析结果显示,未应用抗病毒治疗的孕产妇与用药的孕产妇相比,其母婴传播的风险高[比值比(OR)=4.349,95%可信区间(CI):1.658~11.408]。结论HIV感染孕产妇应用抗病毒治疗、分娩方式、儿童预防性应用抗病毒治疗等因素,与暴露儿童最终感染状态有关,孕产妇应用抗病毒治疗是降低母婴传播风险的关键性因素。     

不同干预措施预防艾滋病母婴传播的效果研究

目的分析河南省对艾滋病病毒(HIV)感染孕产妇,采用不同干预措施预防母婴传播的效果。方法采用随访研究的方法,利用国家预防母婴传播干预(PMTCT)管理信息网络直报系统,以2004年1月至2012年12月确诊报告的863例HIV-1感染孕产妇及其所分娩的婴儿为研究对象,收集和整理孕产妇接受抗反转录病毒药物、安全助产和婴儿喂养指导等预防艾滋病母婴传播干预措施的实施服务情况,收集HIV感染孕产妇定期随访和婴儿的检测信息,掌握婴儿的HIV感染状态,分析干预措施对HIV母婴传播效果的影响。结果 HIV感染孕产妇所生的863名婴幼儿中,有47名感染HIV,艾滋病母婴传播率为5.45%。对不同方案的药物干预措施进行比较,联合、单一和未应用抗病毒药物的孕产妇,其母婴传播率分别为2.02%、3.16%、14.93%。在市、县、乡及以下助产机构分娩的感染孕产妇的母婴传播率分别为2.56%、4.44%和20.31%。孕早期(12孕周)接受艾滋病咨询检测服务的产妇,其母婴传播率低于孕中晚期(≥12孕周)产妇(3.08%、6.47%)(χ2=4.63,P0.01),人工喂养婴儿发生母婴传播率低于非人工喂养婴儿(4.84%、14.04%)(χ2=7.05,P0.01)。多因素分析表明,产妇孕早期接受艾滋病咨询检测服务[比值比(OR)=0.24,95%可信区间(CI):0.02~1.98],产妇孕早期服用抗病毒药物(OR=0.25,95%CI:0.09~0.69)、使用联合用药方案(OR=0.07,95%CI:0.02~0.28)、婴幼儿采取人工喂养(OR=0.16,95%CI:0.07~1.03),是PMTCT的保护因素。结论艾滋病母婴传播的不同干预措施有效降低了艾滋病母婴传播水平。     

实施预防HIV母婴传播措施效果分析

目的了解实施预防艾滋病母婴传播措施对艾滋病病毒(HIV)母婴传播的影响。方法对实施干预试点地区阳性孕产妇及所生幼儿干预状况进行调查,调查幼儿出生时服药情况、喂养方式,及其母亲的分娩方式、服用抗病毒药物等情况,采用单因素χ2分析,比较干预组与未干预组幼儿HIV感染率的差异。结果实施综合干预措施组HIV母婴传播率为2.75%,没有采取任何干预措施组的母婴传播率为50.00%,两组间存在显著性差异。结论对HIV阳性孕产妇及所生婴儿及时服用抗病毒药物,并对婴儿实施纯人工喂养等措施,可有效降低HIV的母婴传播率。     

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。     

Desire for Children and Pregnancy Risk Behavior among HIV-Infected Men and Women in Uganda

To identify ways to improve prevention of mother-to-child transmission (PMTCT) of HIV, we conducted a cross-sectional study of 1,092 HIV-infected men and women attending an AIDS support organization in Jinja, Uganda, between October 2003 and June 2004. Pregnancy risk behavior was defined as having sex without contraceptive or condom. Overall, 42% of participants were sexually active, 33% practiced pregnancy risk behavior, and 18% desired more children. Men were almost four times to want more children than the women (27% vs. 7%). Among those practicing pregnancy risk behavior, 73% did not want more children and were at high risk for unwanted pregnancies. Although 81% knew that mother-to-child transmission of HIV could be prevented, only 22% believed that an HIV-infected woman who received PMTCT therapy could still deliver an HIV-infected child. Lack of MTCT information, having attended the program for ≤2 years and desire for children were independently associated with pregnancy risk behavior. PMTCT and other HIV prevention and care programs should ensure provision of family planning for HIV-infected populations who do not want to become pregnant.     

广州市41例HIV感染孕产妇干预情况分析

目的了解广州市孕产妇艾滋病病毒（HIV）感染的特征及母婴阻断情况,为进一步做好艾滋病母婴阻断提供依据。方法 2009年10月至2010年9月,对接受婚检、产检及助产服务的孕产妇进行HIV筛查,阳性个案进行确诊试验。对HIV感染孕产妇及其新生儿的一般情况、干预效果进行分析。结果广州市全人口孕产妇HIV抗体阳性检出率为0.02%（41/178 029）。HIV感染孕产妇平均年龄27岁,绝大多数为汉族,受教育程度偏低,大部分无业或农民;最可能的感染途径是性传播。76.9%（30/39,2例失访）的孕产妇顺利分娩;分娩产妇中母亲用药率为56.7%（17/30）,婴儿用药率为60.0%（18/30）;46.7%（14/30）的婴儿成功随访至结案,未检出HIV感染个案。结论母婴阻断效果明显。在母婴阻断干预过程中,HIV感染孕产妇及其婴儿的随访工作难度较大,要根据孕产妇人群的特点有针对性地开展工作。     

Effectiveness of a PMTCT programme in rural Western Kenya

We assess the coverage of a Prevention of Mother-to-child Transmission (PMTCT) programme in Busia (Kenya) from 1 January 2006 to 31 December 2008 and estimate the risk of transmission of HIV. We also estimate the odds of HIV transmission according to pharmacological intervention received. Programme coverage was estimated as the proportion of mother-baby pairs receiving any antiretroviral (ARV) regimen among all HIV-positive women attending services. We estimated the mother-to-child transmission (MTCT) rate and their 95% confidence interval (95%CI) using the direct method of calculation (intermediate estimate). A case-control study was established among all children born to HIV-positive mothers with information on outcome (HIV status of the babies) and exposure (data on pharmacological intervention). Cases were all HIV-positive children and controls were the HIV-negative ones. Exposure was defined as: (1) complete protocol: ARV prescribed according World Health Organisation recommendations; (2) partial protocol: does not meet criteria for complete protocol; and (3) no intervention: ARVs were not prescribed to both mother and child. Babies were tested using DNA Polymerase Chain Reaction at six weeks of life and six weeks after breastfeeding ceased. In the study period, 22,566 women accepted testing, 1668 were HIV positive (7.4%; 95%CI 7.05-7.73); 1036 (62%) registered in the programme and 632 were lost. Programme coverage was 40.4% (95%CI 37.9-42.7). Out of the 767 newborns, 28 (3.6%) died, 148 (19.3%) defaulted, 282 (36.7%) were administratively censored and 309 (40.2%) babies completed the follow-up as per protocol; 49 were HIV positive and MTCT risk was 15.86% (95%CI 11.6-20.1). The odds of having an HIV-positive baby was 4.6 times higher among pairs receiving a partial protocol compared to those receiving a complete protocol and 43 times higher among those receiving no intervention. Our data show a good level of enrolment but low global coverage rate. It demonstrates that ARV regimens can be implemented in low resource rural settings with marked decreases of MTCT. Increasing the coverage of PMTCT programmes remains the main challenge.     

Prevention of Mother-to-Child Transmission of HIV in Yaounde: Barrier to Care

Most HIV-infected children in Sub-Saharan Africa are born where programs for the prevention of mother-to-child transmission of HIV (PMTCT) exist but are not universally operational. The expansion of PMTCT programs in Cameroon was among the largest in francophone Africa, but despite highly variable estimates of PMTCT uptake (ranging from 20% to 66%), it is clear that not enough HIV-infected pregnant Cameroonian women benefit from treatment to prevent HIV transmission to their children. The reasons why HIV-infected women in Cameroon do not use treatments to prevent this transmission remain partially unidentified. We conducted a qualitative study of the therapeutic itineraries (treatments taken and motivations) followed by HIV-infected pregnant women in Cameroon to understand the barriers to accessing high-quality PMTCT care. Here we construct the therapeutic itinerary for HIV-infected pregnant women, and identify the barriers at each step. Lack of financial independence, personal support, and empowering information were the primary obstacles at multiple steps.     

Reduction in mother-to-child transmission of HIV in Thailand, 2001-2003: Results from population-based surveillance in six provinces

BACKGROUND: In 2000, Thailand implemented a national program to prevent mother-to-child HIV transmission (PMTCT). OBJECTIVE: To describe the effectiveness of the prevention of mother-to-child HIV transmission program in Thailand. DESIGN AND METHODS: A register of HIV-exposed children at birth was created with follow-up of infection status. The register included children born to HIV-infected women between 1 January 2001 and 31 December 2003 at 84 public health hospitals in six provinces of Thailand. The main outcome measure was HIV infection in children. RESULTS: A total of 2200 children born to HIV-infected mothers were registered. Of these mother-infant pairs, 2105 (95.7%) received some antiretroviral prophylaxis, including 1358 (61.7%) who received the complete short-course zidovudine regimen during pregnancy and labor for the mother and after birth for the infant, with or without other antiretrovirals. HIV infection outcome was determined for 1667 (75.8%) children, of whom 158 [9.5%, 95% confidence interval (CI), 8.1-11.0%] were infected. Transmission risk was 6.8% (95% CI 5.2-8.9%) among 761 mother-infant pairs that received the complete zidovudine regimen alone, and 3.9% (95% CI, 2.2-6.6%) among 361 mother-infant pairs that received the complete zidovudine regimen combined with other antiretrovirals, usually nevirapine. The overall transmission risk from this cohort, including all antiretroviral prophylaxis combinations, is estimated to be 10.2%. CONCLUSIONS: The Thai national PMTCT program is effective in reducing mother-to-child transmission risk from the historical risk of 18.9-24.2%. The addition of nevirapine to short-course zidovudine beginning in 2004 may further improve program effectiveness in Thailand.     

Risk factors for perinatal transmission of HIV among women attending prevention of mother-to-child transmission clinics in Northwest Nigeria

Despite the effectiveness of antiretroviral therapy (ART) in the prevention of mother-to-child transmission of HIV (PMTCT), some HIV-infected women in PMTCT care are at risk of transmitting HIV to their babies. Using a 1:1 unmatched case–control study design, we assessed the risk factors for perinatal transmission among women who received ART for PMTCT in Sokoto State, Nigeria. Data were abstracted from medical records of cases (94 HIV-infected babies) and controls (94 HIV-uninfected babies) and their mothers who accessed PMTCT services in three purposefully selected secondary health facilities. We conducted univariate and multivariate logistic regressions to determine if sociodemographic characteristics, time of enrolment, type of maternal ART, receipt of infant antiretroviral (ARV) prophylaxis, place of delivery, or feeding practice were associated with HIV infection among HIV-exposed babies. Sixteen percent of the mothers of babies in the case group had early enrolment while 90% of those in the control group enrolled early. Infant prophylaxis was received in 54% of cases and 95% of controls. In both groups, 99% of the mothers practiced mixed feeding. In the univariate analysis, factors that were significantly associated with HIV infection were religion (islam), rural residence, late? enrolment, and non-receipt of infant ARV prophylaxis. In the multivariate analysis, rural residence (Adjusted odds ratio (aOR)?=?8.01, 95% CI?=?1.79–35.78), late enrolment (aOR?=?41.72, 95% CI?=?15.16–114.79), and non-receipt of infant ARV prophylaxis (aOR?=?4.1, 95% CI?=?1.18–14.33) remained statistically significant. Findings from this study indicate that eliminating MTCT in Nigeria requires interventions that will enhance timely access of ART by mother-baby dyads.     

HAART预防艾滋病母婴传播的可行性和有效性

目的总结和分析在云南省边远的农村地区,对孕妇实施高效反转录病毒治疗（HAART）以预防艾滋病病毒（HIV）母婴传播（PMTCT）的有效性和可行性。方法梳理和定量分析2005—2012年,云南省与美国艾伦戴蒙德艾滋病研究中心开展的预防艾滋病母婴传播项目的效果。结果在1861名HIV阳性孕妇中,1353名孕妇（72．7％）采用了HAART阻断方案。在1584名有HIV检测结果的婴儿中,阳性25人,阳性率为1．58％;其中1168名采用HAART妇女所生的婴儿中,仅有9人阳性,阳性率为0．8％;在孕28周前开始HAART的妇女所生婴儿中,HIV阳性率为0．2％（2／899）。结论HAART对于阻断HIV母婴传播效果非常显著,如果在孕28周前开始HAART,婴儿HIV感染率已经非常接近“零感染”的目标,可以推广和实施。     

“四免一关怀”政策实施10年中国艾滋病防治主要进展

目的分析"四免一关怀"政策实施以来,中国艾滋病防治在检测、抗病毒治疗、预防母婴传播以及高危人群预防干预等方面重点工作的主要进展。方法利用国家艾滋病综合防治信息系统收集的信息进行分析,展示2004-2013年开展艾滋病检测的机构数、检测人次数及发现的感染者人数、抗病毒治疗人数及机构数,孕产妇检测人数及阳性孕产妇抗病毒治疗药物应用率,美沙酮治疗人数及机构数等主要防治工作指标的进展。结果 2004-2013年间,具备艾滋病病毒(HIV)初筛和确认检测能力的实验室分别增加6.1和7.9倍,年检测人数增加近5倍,2013年达1.11亿人次,当年新确诊病例90 119人。抗病毒治疗当年新增治疗人数增加7.4倍,截止2013年底,全国累计治疗282 529人,在治227 489人。目前使用8种抗病毒治疗药品,5个品种为国内仿制。累计为5000万名孕产妇提供了HIV抗体检测,2013年阳性孕产妇抗病毒药物应用率达到80.9%。美沙酮维持治疗门诊数从8个扩大到763个,至2013年底累计治疗41.27万人,在治20.17万人。10年间,中央财政艾滋病防治专项经费增加3.8倍。结论落实"四免一关怀"政策的10年里,中国艾滋病防治工作在检测发现感染者、抗病毒治疗、预防母婴传播,以及高危人群干预等方面的工作取得了显著进展。     

Efficacy of antiretroviral drugs in reducing mother-to-child transmission of HIV in Africa: a meta-analysis of published clinical trials

Antiretroviral drugs (ARVs) have been shown to be efficacious in decreasing mother-to-child transmission (MTCT) of HIV. A summary estimate of the efficacy of ARVs in reducing MTCT is important for modeling and policy decisions. However, no one has hitherto attempted to generate this summary estimate for Africa, the continent with the greatest HIV/AIDS burden. This study estimates the efficacy of ARVs in reducing MTCT in Africa through a meta-analysis of published studies conducted in Africa. Using an a priori protocol, Medline, EMBASE, and the Cochrane Library were searched for primary studies that measured MTCT of HIV, had ARVs as the exposure to the mother, and were conducted in Africa. Extracted data included characteristics of the study, population, quality, exposure, and results. The data were analyzed using a random effects model with each trial arm as a data point. Ten randomized clinical trials conducted in West, East, and Southern Africa published from 1999 to 2007 satisfied the inclusion criteria. They ranged in sample size from 139 to 1797, and used different ARV regimens as the exposure to the mother antepartum, intrapartum, or postpartum, and to the baby. The combined effect estimate of using ARVs is 10.6% (95% CI: 8.6-13.1) transmission at 4-6 weeks and 21.0% (95% CI: 15.5-27.7) transmission for placebo. This represents approximately 50% efficacy. The result is stable and not driven by any single study. All regimens were well tolerated. We conclude that ARV use to reduce MTCT of HIV in Africa is efficacious and well tolerated.     

四川省不同地区孕产妇HIV抗体检测情况分析

目的了解四川省孕产妇接受艾滋病病毒（HIV）抗体检测服务的情况,为扩大预防母婴传播覆盖面而制定全省相关政策提供依据。方法2008-2010年,收集四川省所有县（市、区）接受孕产期保健的孕产妇艾滋病检测情况,按不同地区进行分析。结果全省孕产妇HIV抗体检测率、孕产妇孕期HIV抗体检测率、住院分娩产妇HIV抗体检测率逐年提高（P〈0．0001）,不同地区的孕产妇HIV抗体检测率、孕产妇孕期HIV抗体检测率、住院分娩产妇HIV抗体检测率不同（P〈0．0001）。按照全省社会经济发展状况由高到低,将全省分为三类区域,一类地区孕产妇的HIV抗体检测率为97．07％,孕产妇孕期HIV抗体检测率为87．42％,住院分娩产妇HIV抗体检测率为97．13%;二类地区孕产妇的HIV抗体检测率为79．70％,孕产妇孕期HIV抗体检测率为44．62％,住院分娩产妇HIV抗体检测率为80．90％;三类地区孕产妇的住院分娩率为56．08％,孕产妇HIV抗体检测率为54．99％,孕产妇孕期HIV抗体检测率为31．06％,住院分娩产妇HIV抗体检测率为88．02％,非住院分娩产妇HIV抗体检测率仅13．13％。结论不同地区孕产妇HIV抗体检测情况差距明显,应采取区域化的应对措施,进一步扩大预防母婴传播覆盖面。