艾滋病病毒母婴传播的研究进展

艾滋病病毒(HIV)可通过性接触、静脉注射、母婴传播三种途径传播。母婴传播是我国家庭内传播的主要方式。HIV的母婴传播可通过三种途径发生：胎儿经胎盘宫内感染，分娩时经产道感染，产生经哺乳感染。母亲的疾病状态、免疫状态及病毒载量等因素与母婴传播有重要的关系。近年在预防HIV母婴传播方面所取得的成就超过了HIV研究的任一方面，现对预防HIV母婴传播的几项措施作一综述。     

中国某地区人类免疫缺陷病毒母婴传播与阻断的调查研究

目的了解人类免疫缺陷病毒在血源性艾滋病流行地区的母婴传播情况，分析影响传播的因素并提出对策。方法现场询问调查和常规体检并采静脉血，检测血清抗-HIV及HIV的前病毒DNA或RNA，分析母亲及其子女配对的资料，回顾性分析HIV的母婴传播。结果107例HIV阳性母亲生育的136名子女中．50例HIV阳性．HIV的母婴传播率为36．8％（50／136）。38例经血感染HIV阳性育龄妇女的外周血基因组核酸扩增HIV前病毒DNA gag区。鉴定均为HIV B’亚型。两埘HIV阳性的母婴的外周血核酸扩增HIV gag区P17的片段，Mega软件分析其基因同源性，分别为95．0％、94．9％。基因树显示子女的病毒与其母亲同属一支。艾滋病状态母亲组HIV母婴传播率为67．4％（31／46）显著高于HIV携带状态母亲组的21．1％（19／90），P〈0．05。奈韦拉平（NVP）阻断的7例儿童．6例末被HIV感染，1例感染HIV。结论被调查地区HIV母婴传播是儿童感染HIV的主要途径。未采取干预措施是造成传播的主要原因。NVP阻断母婴传播较易被接受并可能减少母婴传播。     

2011—2020年芜湖市HIV感染孕产妇母婴阻断情况分析

目的 分析芜湖市孕产妇HIV感染及母婴阻断情况,为进一步完善HIV感染孕产妇母婴阻断措施提供科学依据。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2011—2020年芜湖市HIV感染孕产妇及所生儿童的相关资料,分析HIV感染孕产妇的检测情况、人群分布特征及母婴阻断干预情况等。结果2011—2020年,芜湖市报告HIV阳性孕产妇50例,平均阳性检出率为16.59/10万。HIV阳性孕产妇平均年龄为（29.54±5.99）岁,以初中文化为主（25例,占50.00%）,职业主要为家务及待业（32例,占64.00%）。感染途径多为性传播（28例,占56.00%）。HIV阳性孕产妇中,选择继续妊娠27例（占54.00%）,终止妊娠21例（占42.00%）,自然流产、失访各1例（各占2.00%）;继续妊娠的孕产妇中,接受CD4+T淋巴细胞检测17例（占62.96%）,接受病毒载量检测6例（占22.22%）,抗病毒用药25例（占92.59%）。选择继续妊娠的孕产妇分娩儿童27例,分娩时均存活,其中儿童抗病毒用药26例（占96.30%）;18月龄HIV检测排除感染24例（占88.89%）,...     

中国人类免疫缺陷病毒-1母婴传播的现状、危机及对策

一、全球人类免疫缺陷病毒 1(ＨＩＶ 1)母婴传播概况ＨＩＶ/ＡＩＤＳ已成为全球儿童的一个主要死因 ,ＨＩＶ感染儿童中有 90 %是由母亲传给的 ,估计全球每年有 2 40万感染ＨＩＶ的妇女生育子女 ,造成每年 60万的新生儿感染病毒。现在每天有 160 0名新生儿感染ＨＩＶ。在非洲 ,ＨＩＶ的流行已使婴儿病死率增加 75 % ,儿童病死率增加10 0 %。在乌干达 ,ＨＩＶ 1感染儿童中 3 4%死于 1岁 ,66%死于 3岁 ,75 %死于 5岁。全球因ＨＩＶ/ＡＩＤＳ的流行而失去双亲的孤儿已超过 110 0万。ＨＩＶ在全球的肆虐使得以性传播为主要途径的发展中国家受到…     

加强阻断艾滋病母婴传播刻不容缓

据医学空间网4月18日报道，我国艾滋病母婴传播正处于快速增长期，母婴传播的感染占全部报告感染的比例已从1998年的千分之一，增加到2003年的千分之六，加强艾滋病母婴传播阻断工作刻不容缓。     

HIV母婴阻断抗病毒治疗线粒体毒性研究进展

抗逆转录病毒治疗可明显降低HIV母婴传播率,但随之带来的药物相关线粒体毒副作用日渐增多,尽可能减少儿童因被动用药带来的器官功能障碍具有重要意义。本文就目前HIV母婴阻断抗病毒治疗对后代的影响进行了综述。     

分娩过程中母婴传播HIV阻断措施

母婴传播HIV是儿童感染HIV的主要途径,占90%;而绝大多数的母婴传播是在接近分娩或产时,占50%-80%;20%的婴儿感染是母乳喂养,助产士在助产过程及产后应对婴儿实施全面的防护措施,要尽其所能地阻断新生儿感染HIV.     

乙肝病毒宫内感染及阻断母婴垂直传播的研究进展

乙肝病毒垂直传播是指ＨＢＶ在亲子代之间的传播方式,包括母婴传播和遗传传递。１.乙肝病毒母婴传播 母婴传播是指患乙肝或者携带ＨＢｓＡｇ的母亲于产前（宫内)、产程中（产道内)或产后不久将ＨＢＶ传给婴儿,并引起婴儿ＨＢＶ感染的过程。母婴传播发生率高低可能与两种因素有关：母体血液中ＨＢｓＡｇ滴度的高低和母体血液中是否含有ＨＢｅ抗原（ＨＢｅＡｇ)。唐氏［１］采用血清学、免疫组织化学和核酸分子杂交方法研究３５例ＨＢｓＡｇ阳性孕妇引产胎儿,结果从胎心血中检测到ＨＢｓＡｇ和抗－ＨＢcIｇM,从胎肝组织查出ＨＢcＡｇ和Ｈ…     

HBV母婴传播及其阻断的研究进展

乙型肝炎是一种严重危害人类健康的传染病。引起乙型肝炎病毒（HBV）慢性感染的主要原因是HBV的母婴传播。近年来，HBV母婴传播的相关研究越来越受到国内外学术界的重视，相关的研究成果也是层出不穷。现将HBV母婴传播的途径、机制、影响因素及阻断方法进行综述。     

Community approaches to preventing mother-to-child HIV transmission: perspectives from rural Lesotho

This paper examines the cultural and structural difficulties surrounding effective prevention of mother-to-child HIV transmission (PMTCT) in rural Lesotho. We argue for three strategies to improve PMTCT interventions: community-based research and outreach, addressing cultural and structural dynamics, and working with the relevant social groups that impact HIV prevention. These conclusions are based on interviews and participant observation conducted within the rural Mokhotlong district and capital city of Maseru, involving women and men of reproductive age, grandmothers serving as primary caretakers, HIV/AIDS programme staff, and medical professionals. Qualitative analysis focused on rural women's socio-medical experience with the four measures of PMTCT (educational outreach, voluntary counselling and testing, antiretroviral interventions, and safe infant feeding). Based on these results, we conclude that intervention models must move beyond a myopic biomedical 'best-practices' approach to address the social groups and contextual determinants impacting vertical HIV transmission. Given the complexities of effective PMTCT, our results show that it is necessary to consider the biomedical system, women and children, and the community as valuable partners in achieving positive health outcomes.     

艾滋病暴露前预防的研究进展

全球艾滋病新发感染依然严峻,干预策略仍然不能普遍有效,亟需新的高效的干预措施整合到生物医学预防-行为预防-社会结构预防的综合模式当中,如暴露前预防。猕猴和小鼠模型证明了它的有效性和安全性,但结果仅限于指导临床试验的设计,因为只有临床试验才能真正说明暴露前预防能否有效阻断艾滋病传播。该策略成功的关键因素有两点：一是个人风险决策;二是社会环境易感性。暴露前预防在艾滋病领域拥有巨大潜能,需要及早纳入计划并拟定相关的应急方案。     

Ritonavir for preventing perinatal HIV transmission

A Thai study on short-term Ritonavir treatment to interrupt perinatal HIV transmission was presented at 6th CROI by S. Limpongsanurak. The safety, tolerability, and efficacy of Ritonavir were examined in a phase IV open-label study involving 86 pregnant women. Ritonavir was given two weeks before their due dates, with dosages gradually increased up to 600 mg twice daily. Breast-feeding was not permitted. Seventy-four mothers completed the study, and perinatal HIV transmission rate was 9.46 percent. In comparison, the rate of perinatal transmission without treatment in the U.S. is 25 percent. Researchers credit Ritonavir with reducing maternal viral load and the rate of perinatal HIV transmission.     

Strategies for preventing late-term vertical HIV transmission

The significant decrease in HIV transmission rates from mother to child (vertical transmission) in developed countries is due largely to the implementation of the three-part AZT protocol. An abbreviated, two-part course of AZT preventive therapy has reduced vertical transmission in developing countries. Cesarean sections (C-sections) performed before the rupture of uterine membranes has also reduced vertical transmission. When elective C-sections are combined with AZT treatment, the rate of transmission drops from 7.3 percent to 2 percent. The mode of infant feeding has played a significant role in vertical transmission in developing countries. Studies suggest breast feeding accounts for more than one-third of all HIV infections in infants. Alternatives to breast feeding may reduce these rates, but issues such as cultural acceptance, formula misuse, and replacement-feeding availability must be addressed.     

Breastfeeding to prevent HIV transmission in infants: balancing pros and cons

PURPOSE OF REVIEW: In industrialized countries avoidance of breastfeeding is among the cornerstones of prevention of mother-to-child transmission of HIV. Breastfeeding carries risk for HIV transmission but improves survival, whereas formula feeding carries zero risk for transmission but increased risk for mortality. We assesses breastfeeding is a rational and viable option for HIV-infected women in poor environments. RECENT FINDINGS: A number of recent studies, mostly from Africa, have provided new data that enable health workers to offer HIV-positive women clear advice on infant feeding appropriate to their individual circumstances. The studies are grouped according to whether the evidence favours one or other feeding type and are considered under the following headings: equivalence of formula feeding and breastfeeding; breastfeeding, HIV disease progression and mortality in mothers; breast superior to formula; breastfeeding for HIV-infected babies; and reducing risk for transmission while breastfeeding. SUMMARY: The weight of current evidence favours exclusive breastfeeding for 6 months to prevent mother-to-child HIV transmission for most HIV-infected mothers globally, most of whom live in poor communities; exclusive breastfeeding may also benefit HIV-infected babies. Formula feeding appears to be equivalent to breastfeeding in terms of survival and transmission risk during the first 2 years of life in some settings.     

HIV整合酶研究进展

HIV整合酶可催化病毒复制周期中的整合过程,即将HIV反转录产物cDNA整合入宿主基因组,它是病毒复制过程不可缺少的酶。抑制该酶活性将能有效抗HIV,迄今尚未在人体内发现整合酶的功能类似物,故整合酶成为抗HIV的理想靶点。本文综述了近年来整合酶的结构、催化活性及影响因素、整合酶抑制剂的研究进展。