龙陵县预防艾滋病母婴传播现状分析

目的:分析笔者所在县母婴阻断工作的结果及现状,探索母婴阻断工作方法,降低艾滋病母婴传播发生率。方法:对2005-2009年进行HIV抗体检测的17613例孕产妇中的72例阳性感染者和53例阳性母亲所生婴儿母婴阻断情况进行分析。结果:孕产妇HIV抗体阳性率为0.41%,经采取干预措施,所生婴儿HIV感染率为零。结论:艾滋病母婴阻断是预防婴儿感染艾滋病的主要手段,采取预防艾滋病母婴传播综合干预措施,能有效降低母婴传播发生率。     

服用抗病毒药物预防艾滋病母婴传播的应用研究

目的对艾滋病病毒感染孕产妇采取服用抗逆转录病毒药物等干预措施,降低艾滋病母婴传播的发生率。方法按照全国预防艾滋病母婴传播的方案,2012年1月~2013年12月对来宾市81例感染艾滋病病毒产妇及其所生82例婴儿(双胞胎1例)按疗程给予足量的抗逆转录病毒药物。按照全国预防艾滋病母婴阻断技术方案要求在婴儿出生42d、12个月和18个月进行随访3次并进行艾滋病早期诊断抗体检测。结果 81例艾滋病病毒阳性孕产妇中74例按疗程服用抗逆转录病毒药物,服药率91.36%。82例艾滋病病毒阳性孕产妇所生婴儿按疗程服用抗逆转录病毒药物,服药率100%。对产后婴儿按照全国预防艾滋病母婴阻断技术方案要求在婴儿出生42d、12个月和18个月进行追踪随访并进行HIV抗体检测,共检出1例艾滋病抗体阳性婴儿,婴儿艾滋病抗体阳性率为1.22%,艾滋病母婴传播阻断效果显著。结论应用抗逆转录病毒药物对感染艾滋病病毒产妇及其所生婴儿进行艾滋病母婴阻断综合干预,对减少艾滋病母婴传播有重要意义。     

广西壮族自治区来宾市艾滋病母婴阻断项目效果评价

目的对艾滋病母婴阻断项目在广西来宾市的实施进行效果评估,为全市预防艾滋病母婴传播提供科学依据。方法在全市实施艾滋病母婴阻断技术,对凡参加孕检的孕产妇免费进行艾滋病咨询检测,对检出阳性者进行艾滋病母婴阻断(感染母亲及所生婴儿按艾滋病母婴阻断技术方案服用抗逆转录病毒药物、实行安全助产和人工喂养指导等)。结果 2010—2015年全市共有207 861例孕产妇参加艾滋病咨询检测,检测率99.17%(207 861/209 600),检出艾滋病抗体阳性325例,检出阳性率0.16%(325/207 861);对检出艾滋病抗体阳性的孕妇纳入艾滋病母婴阻断系统管理,通过卫生咨询指导,告知患者艾滋病的传播方式及其危害性、预防措施和伦理等知情选择,最后自愿选择终止妊娠87例,选择生育的238例;238例艾滋病抗体阳性者中有227例按艾滋病母婴阻断技术方案全程足量服用抗逆转录病毒药物,服药率95.38%(227/238);活产婴儿232例,按艾滋病母婴阻断技术方案全程足量服用抗逆转录病毒药物221例,服药率95.26%(221/232);而后按艾滋病母婴阻断技术方案对出生婴儿满42天和3个月进行艾滋病早期诊断,检出阳性1例,检出阳性率0.45%;最后对198例出生满18个月婴儿,进行艾滋病抗体检测,未捡出艾滋病抗体阳性者。结论孕产妇在进行正常孕产检时同时进行艾滋病咨询检测,对艾滋病的早期发现,可以取得事半功倍的效果;对检出艾滋病阳性孕妇及所生婴儿采取艾滋病母婴阻断综合性预防措施,是预防艾滋病母婴传播的有效方法。     

西双版纳州勐海县预防艾滋病母婴传播服务现状与思考

目的分析西双版纳州勐海县预防艾滋病母婴传播服务现状,科学评价勐海县艾滋病母婴传播阻断措施。方法 2005年至2009年,勐海县辖区提供孕产期保健和助产服务的医疗机构按照《云南省预防艾滋病母婴传播实施方案》要求,对所有孕产妇开展HIV抗体免费咨询、检测和母婴阻断服务,对上报资料进行分析。结果勐海县同期孕产妇HIV抗体咨询率为92.89%,抗体检测率为92.38%,HIV感染孕产妇抗病毒药物服药率为86.67%,HIV感染孕产妇所生婴儿抗病毒药物服药率、人工喂养率、住院分娩率均为100%,9例18月龄HIV感染产妇所生婴儿HIV抗体检测结果阴性。结论勐海县预防艾滋病母婴传播工作措施有力,成效明显,通过母婴阻断,降低了婴幼儿感染艾滋病的风险,提高了儿童生存质量。     

艾滋病母婴阻断技术在广西少数民族地区的应用

目的探讨艾滋病母婴阻断技术在来宾地区婚检、产检人群的临床应用提供科学依据。方法利用免费婚检、免费产检平台对婚检、产检人群进行艾滋病（HIV）咨询检测筛查,找出艾滋病（HIV）感染者,对艾滋病（HIV）感染孕妇建议终止妊娠。坚持生育者对其及其所生婴儿进行母婴阻断干预,以避免艾滋病母婴传播发生。结果全市2011—2012年平均婚检率95．87％（90555／94454）、平均产检率98．99％（73591／74341）;婚检、产检人群二年内检出艾滋病（HIV）阳性291例,检出阳性率0．18％。其中检出艾滋病（HIV）阳性孕产妇103例,检出阳性率0．14％。103例孕产妇中,巳终止妊娠18例、分娩活产79例、死胎1例、仍在孕5例。分娩活产孕产妇服用抗病毒药物76例,服药率96．20％,婴儿服用抗病毒药物77例,婴儿系统管理服药率97．47％,死亡婴幼儿1例,失访2例,阳性孕产妇所生婴幼儿产时未检出（HIV）感染者。结论利用婚检、产检平台进行艾滋病咨询检测筛查,可以尽早发现艾滋病（HIV）感染者;对艾滋病（HIV）感染者建立档案并进行跟踪、开展婚育卫生指导、怀孕者建议终止妊娠,可避免艾滋病儿出生;坚持生育者进行艾滋病母婴阻断系统管理,对预防艾滋病母婴传播发生具有非常重要的意义。     

52例感染艾滋病病毒孕产妇母婴阻断效果分析

目的观察探讨感染艾滋病病毒孕产妇母婴阻断效果,总结其临床意义。方法选取我院2009年1月至2010年6月52例感染艾滋病病毒孕产妇,随机分为观察组和对照组各26例,观察组采取综合性的母婴阻断措施,对照组不采取任何母婴阻断措施,观察对比2组分娩方式、分娩结局、婴儿HIV感染情况及婴儿喂养方式,进行统计学分析。结果 2组分娩方式、分娩结局、婴儿HIV感染情况及婴儿喂养方式对比差异显著（P〈0.05）,具有统计学意义。结论及时发现并及早对感染艾滋病病毒孕产妇采取选择性剖宫产、母婴抗病毒药物综合性治疗和人工喂养等干预措施,能有效预防HIV母婴传播,降低新生儿死亡率,具有重要的临床意义。     

农村预防艾滋病母婴传播关键技术研究

目的探索预防艾滋病母婴传播关键技术,降低艾滋病母婴传播率．方法采用流行病学现场干预试验,探索提高孕妇艾滋病自愿咨询检测率的措施．采用临床研究方法开展艾滋病母婴传播干预实验研究,将艾滋病病毒（HIV）感染孕产妇随机分为两组,分别给予HIV感染孕产妇及其所生新生儿两种抗反转录病毒药物方案（齐多夫定（AZT）与耐韦拉平（NVP）联合方案和单一NVP方案）阻断治疗,并实施住院分娩、人工喂养等措施．结果获得了促进农村妇女孕早、中期HIV抗体自愿咨询检测综合策略．通过干预,研究点妇女孕28周前HIV抗体检测率、孕28周前自愿咨询检测率分别上升了50．4％和60．9％;研究点研究期间接受HIV母婴阻断系列服务122例,完成112例婴儿追踪随访,阻断成功107例,阻断成功率达到95．5％,AZT＋NVP联合方案母婴传播率降至1．8％,单一NVP方案母婴传播率降至7．0％．结论促进农村妇女孕早、中期HIV抗体自愿咨询检测综合措施与抗病毒治疗,结合住院分娩和婴儿人工喂养能显著地降低艾滋病母婴传播率．     

河南省2002—2014年预防艾滋病母婴传播干预工作效果研究

目的了解2002—2014年河南省预防艾滋病母婴传播干预工作的效果。方法对HIV感染产妇及其分娩婴儿进行随访,收集不同年度干预措施实施情况及分娩婴儿的生存感染状况,分析不同干预措施对艾滋病母婴传播的影响,采用非条件Logistic回归探索艾滋病母婴传播的有关因素。结果截止2014年12月31日,共对10 208 941名孕产妇提供HIV检测咨询,发现HIV感染孕产妇2 428人,HIV检测阳性率为0.024%,孕产妇HIV检测阳性率呈现逐年递减趋势(χ~2=4.88,P=0.027)。分娩的1 673名婴儿中,有1 515人存活且满18月龄,已经死亡儿101人,失访57人。1 515名婴儿中阳性60人,阴性1 324人,存活婴儿HIV母婴传播率为4.22%,校正死亡后HIV母婴传播率为6.25%。干预措施中产妇药物阻断率为76.96%,婴儿药物阻断率为92.5%,孕早期接受HIV检测率为70.5%。多因素分析显示,孕早期接受预防艾滋病母婴传播服务(OR=0.23,95%CI:0.07~0.72),抗病毒药物阻断(OR=0.46,95%CI:0.23~0.95),婴幼儿采取人工喂养(OR=0.09,95%CI:0.02~0.35)是艾滋病母婴传播的保护因素,产妇分娩过程采取侧切操作(OR=3.52,95%CI:1.49~8.27)是其危险因素。结论河南省预防艾滋病母婴传播综合干预措施比较完善,孕产妇HIV检测阳性率保持在较低水平,但HIV暴露婴儿的母婴传播率及婴儿死亡率较高,应有针对性地加强综合干预措施。     

不同用药方法阻断艾滋病母婴传播73例临床观察

目的 观察不同用药方法 阻断艾滋病母婴传播效果.方法 2005~2007年应用维乐命方案（方案1）阻断HIV母婴传播26例,2008~2010年联合应用三联抗病毒药物方案（方案2）阻断HIV母婴传播47例.所出生的婴儿均采用人工喂养,随访观察至18月龄.结果 两种方案出生的婴儿外观均未见畸形,方案1出现2例婴儿HIV阳性（母儿均服药及仅婴儿服药各1例）;方案2出现1例婴儿HIV阳性（仅婴儿服药）,母儿均服药均为阴性.结论 对HIV阳性孕妇采取综合干预措施（抗病毒药物治疗、婴儿人工喂养）能有效阻断HIV母婴传播.     

HIV感染母婴阻断26例临床观察

目的探讨人类免疫缺陷病毒（HIV）感染孕产妇母婴阻断的措施及其效果，控制儿童获得性免疫缺陷综合征（AIDS）的发生流行。方法对我院2007年6月-2011年12月收治的经自治区疾病预防控制中心确诊的26例HIV阳性孕产妇及所产婴儿进行回顾性分析。结果26例HIV阳性孕产妇2例自愿终止妊娠，余24例均实施药物阻断，所产新生儿除1例阳性外其余均为阴性，阻断成功率95．83％。结论综合性HIV母婴阻断措施是降低HIV母婴传播率的关键。     

The Prevalence of HIV Drug Resistance among Treatment-failure Individuals and Treatment-nave Individuals in China:A Meta-analysis

Objective To understand drug resistance prevalence among treatment-failure and treatment-nave HIV-positive individuals in China.Methods We searched five electronic databases(Wanfang,CNKI,CQVIP,SinoMed,and Pubmed) for studies of HIV drug resistance.Random-effects models were carried out to estimate the prevalence of drug resistance among treatment-failure and treatment-nave individuals,respectively.Results The estimated nationwide rates of HIV drug resistance to any-class drugs among treatment-failure and treatment-nave individuals were 57%(95% CI:49%-65%) and 3.23%(95% CI:2.47%-4.07%),respectively.Among the drug classes,the prevalence of resistance to PIs was low(1.45%;95% CI:0.73%-2.33%) in treatment-failure individuals,although high rates of resistance to NNRTIs(54%;95% CI:45%-63%) and NRTIs(40%;95% CI:32%-49%) were found.Resistance to any-class drugs,NNRTIs and NRTIs manifested regional differences,but resistance to PIs did not.Positive correlations were observed between resistance to NNRTIs and NRTIs among treatment-failure and treatment-nave individuals,respectively.Conclusion The prevalence of HIV drug resistance to NNRTIs and NRTIs among treatment-failure individuals was high.In contrast,the prevalence of drug resistance among treatment-nave individuals was low.The epidemics of drug resistance matched current treatment strategies and interventions in China.Surveillance for HIV drug resistance is necessary to assess the sustainability and durability of current treatment regimens.     

Use of interventions for reducing mother-to-child transmission of HIV in Australia

OBJECTIVE: To describe the extent and outcome of use of interventions for reducing the risk of HIV transmission from mother to child in Australia. DESIGN: National surveillance for perinatal exposure to HIV. PARTICIPANTS AND SETTING: Notified cases of HIV infection in women in Australia and their perinatally exposed children, 1982-1999. OUTCOME MEASURES: Trends over time in use of interventions (antiretroviral therapy in pregnancy, elective caesarean delivery and avoidance of breastfeeding) and perinatally acquired HIV infection. RESULTS: By 31 March 2000, 204 children were reported as having been born in 1982-1999 to 162 women whose HIV infection had been diagnosed by 31 December 1999. The child's HIV infection status was established for 182 (89.2%); the mother's HIV infection was diagnosed antenatally in 91 of these cases (50%). Among women diagnosed antenatally, use of elective caesarean delivery and antiretroviral therapy in pregnancy increased significantly, from 3% and 14% by women whose children were born in 1982-1993, to 21% (P=0.01) and 88% (P<0.001), respectively, by women whose children were born in 1994-1999. Most women (95%) diagnosed antenatally avoided breastfeeding their children. The percentage of infected children born to women diagnosed antenatally declined from 26% among children born in 1982-1993 to 19% among those born in 1994-1999. The percentage of infected children was significantly lower among those whose mothers used antiretroviral therapy in pregnancy (11% versus 36%; P=0.03). CONCLUSION: Antiretroviral use in pregnancy, elective caesarean delivery and avoidance of breastfeeding have been effective interventions for reducing the risk of mother-to-child HIV transmission in Australia. While the rate of perinatal HIV transmission has declined, it remains high in comparison with rates reported from other industrialised countries.     

HIV感染孕产妇启动抗病毒治疗情况及影响因素分析

  目的  HIV感染孕产妇抗病毒治疗比例是妇女发展纲要重点考核指标,我省该项指标达标情况不容乐观,本研究主要分析我省近20年HIV感染孕产妇抗病毒治疗率及其影响因素,为提高我省治疗率提供科学依据。  方法  通过《预防艾滋病、乙肝、梅毒母婴传播管理信息系统》下载2004—2020年期间HIV确诊阳性的孕产妇的EXCEL数据库,包括孕产妇基本信息、丈夫或性伴侣信息、孕产妇抗艾滋病病毒药物使用情况等。采用Pearson χ2检验、Poisson回归模型分析数据。  结果  2004—2020年我省共报告834名HIV感染孕产妇病例,平均年龄为(28.65±6.39)岁。我省HIV感染孕产妇孕产期启动抗病毒治疗(antiviral therapy, ART)率呈现逐年增长趋势,从2004—2010年期间的57%(61/107)增长到2020年的95%(19/20,趋势χ2=47.658,P < 0.001)。多因素Poisson回归模型分析结果显示,与产后确诊的孕产妇相比,孕前、孕期、产时确诊的孕产妇启动ART的可能性分别增大了5.15倍(95% CI:2.91~9.13)、5.06倍(95% CI:2.85~8.97)和1.83倍(95% CI:1.00~3.64)。  结论  本研究结果提示,可通过加强孕产妇的管理,将发现孕产妇感染的时期前移至孕前,这对提高艾滋病母婴阻断效果具有重大意义。      

深圳地区新近诊断HIV-1感染者的传播耐药性检测

目的:通过对深圳地区人类免疫缺陷病毒1型(HIV-1)新近感染者耐药基因型的研究,了解当地HIV-1耐药株传播水平。方法:收集198例2009年3月～2011年10月新确诊的、年龄>20岁的HIV-1感染者的血浆样本,使用一步法RT-PCR和巢式PCR扩增Pol区蛋白酶基因全长(1～99aa)和逆转录酶区前部分基因(1～300aa),并进行耐药基因变异分析。结果:PCR扩增阳性且测序成功163例,总的耐药比例为17.2%(28/163,95%CI 11.4%～22.9%),其中3.7%(6/163,95%CI 1.1%～6.5%)对蛋白酶抑制剂(PIs)耐药,10.4%(17/163,95%CI 5.7%～15.1%)对核苷类逆转录酶抑制剂(NRTIs)耐药,11.7%(19/163,95%CI 6.8%～16.6%)对非核苷类逆转录酶抑制剂(NNRTIs)耐药。结论:深圳地区HIV-1新近感染者中耐药率高达17.2%,对新近HIV-1感染者进行连续耐药性检测是有必要的。     

The outcome of prevention of mother-to-child transmission of HIV infection at King Abdulaziz University Hospital,Western Region of Saudi Arabia: A Descriptive Study

Objectives:To describe the effectiveness of HIV guidelines in prevention of mother-to-child transmission (PMTCT).Methods:A retrospective review from January 2009 to December 2018 at the King Abdulaziz University Hospital (KAUH), Jeddah, Kingdom of Saudi Arabia. The main outcome measures were characteristics of HIV-exposed patients and transmission rate.Results:A total of 18 HIV-positive mothers and their 26 infants were included. The mean age of mothers at delivery was 31.69 years, and 50% were under 30 years old. All mothers received lifelong ART, except one who was not diagnosed until the 27th week of gestation. Among the mothers, 83% complied with treatment regimens, and 11% had ART resistance. Human immunodeficiency virus polymerase chain reaction (PCR) was undetectable in 19 pregnancies. Seven mothers had opportunistic infections and treatment was immediately initiated. After reviewing the infants’ HIV PCR tests, the transmission rates of HIV were 0% for both spontaneous vaginal delivery and cesarean section.Conclusion:Many challenges face the efforts to decrease vertical HIV transmission, and a particular focus on the transitions between stages of care is needed. We believe that early screening, counseling, and regular follow-up have contributed to MTCT elimination.     

Herpes Simplex Virus Type 2 Risks in Female Sex Workers in the China-vietnam Border County of Hekou

ObjectiveTo survey the prevalence and risk factors of HSV-2 among Chinese and Vietnamese female sex workers (FSW) in the border county of Hekou, Yunnan Province, China.MethodsA cross-sectional survey was conducted on demographics, sexual behavior, medical history, and drug use among FSWs. Laboratory samples were obtained to test for HSV-2 and other STIs such as HIV, Syphilis, Trichomonas vaginalis, Neisseria gonorrhoeae, Chlamydia trachomatis, Bacterial vaginosis, and Yeast infections. Cervicitis and genital warts were also diagnosed.ResultsOf the 345 FSWs who participated in this study, 112 (32.5%) were ethnic Chinese and 233 (67.5) were Vietnamese. Among FSWs in Hekou, the prevalence rates were 58.3% for HSV-2, 5.5% for HIV, and 4.1% for bacterial vaginosis (BV). Age <21 (OR: 0.5; 95% CI: 0.3, 0.8), duration of commercial sex work ≤3 months (OR: 0.5; 95% CI: 0.3, 0.8), oral and vaginal sex with the last client (as opposed to only vaginal sex) (OR: 1.6; 95% CI: 1.0, 2.7), HIV (OR: 11.4; 95% CI: 1.5, 87.2), and bacterial vaginosis (BV) (OR: 5.6; 95% CI: 1.2, 26.9) were significantly correlated with HSV-2 infection.ConclusionMultivariate analysis showed that several factors were significantly correlated with the high prevalence of HSV-2 in FSWs in the border area between China and Vietnam. Further studies and interventions are needed for HSV-2 epidemiology in the border area.     

Lamivudine-zidovudine combination for prevention of maternal-infant transmission of HIV-1

CONTEXT: Zidovudine reduces maternal-infant transmission of human immunodeficiency virus 1 (HIV-1) infection by two thirds. Combination antiretroviral therapies are potentially more effective prevention. OBJECTIVES: To assess the safety of perinatal lamivudine-zidovudine therapy, especially in children, and its effects on viral load, acquisition of drug resistance, and maternal-infant transmission of HIV-1 in a nonbreastfeeding population. DESIGN AND SETTING: The Agence Nationale de Recherches sur le SIDA (ANRS) 075 Study, an open-label, nonrandomized intervention trial conducted in the context of an ongoing observational cohort study in 48 sites in France. PATIENTS: A total of 445 HIV-1-infected pregnant women were enrolled as the study cohort from February 1997 to September 1998; controls consisted of 899 pregnant women who had received zidovudine monotherapy in May 1994 to February 1997 as standard care. INTERVENTION: The study cohort received lamivudine in addition to the standard Pediatric AIDS Clinical Trial Group 076 Study zidovudine prophylaxis regimen. Lamivudine was initiated in women at 32 weeks' gestation through delivery at 150 mg twice per day orally; children received lamivudine, 2 mg/kg twice per day for 6 weeks. MAIN OUTCOME MEASURES: HIV-1 infection status and tolerance of therapy in children through age 18 months; maternal plasma HIV-1 RNA levels through 6 weeks after delivery. RESULTS: The transmission rate in the study group was 1.6% (7/437; 95% confidence interval [CI], 0.7%-3.3%). In a multivariable analysis, transmission in the study group was 5-fold lower than in controls. In the study group, maternal plasma HIV-1 RNA level was less than 500 copies/mL at delivery in 74%; the median decrease was 1.24 (range, -1.63 to 3.40) log(10) copies/mL. The M184V lamivudine resistance mutation was detected at 6 weeks after delivery in specimens from 52 of 132 women. The most frequent serious adverse events in children were neutropenia and anemia, requiring blood transfusion in 9 children and premature treatment discontinuation in 19. Two uninfected children died at age 1 year from neurologic complications related to mitochondrial dysfunction. CONCLUSIONS: Lamivudine-zidovudine may be effective in preventing maternal-infant HIV transmission. However, severe adverse effects and emergence of resistance to lamivudine occurred. Thus, the role of this combination therapy in this setting is as yet unclear, and further research involving a variety of strategies is needed to definitively ascertain its utility for preventing maternal-infant HIV transmission.     

云南省保山市1990—2020年HIV/AIDS病例生存分析

目的 通过对云南省保山市1990—2020年艾滋病病毒（HIV）感染者/艾滋病（AIDS）病人（简称HIV/AIDS）生存时间及其影响因素进行全面分析,为提高HIV/AIDS病人生存质量提供科学依据。方法 运用回顾性队列研究方法, 计算1990—2020年保山市6 838例HIV/AIDS病人的生存率;用Cox比例风险模型分析生存时间的影响因素。结果 6 838例HIV/AIDS病人,全死因死亡1 757例（25.69%）,平均生存时间为19.51年（95%CI:18.51~20.51）;随着防控措施的强化,相对于2005年以前的第一个时期,后三个时期5年生存率均有所升高而死亡风险均下降。多因素Cox比例风险模型分析发现,HIV/AIDS生存的相关影响因素包括性别（男比女：HR=1.223,95%CI=1.094~1.367）、确诊年龄（40~<50岁比15~<25岁：HR=1.743,95%CI=1.110~2.739;50~<60岁比15~<25岁：HR=2.092,95%CI=1.306~3.351;≥60岁比15~<25岁：HR=3.179,95%CI=1.984~5.094）、感染途径（经注射吸毒传播比经异性传播：HR=0.694,95%CI:0.58~0.83）、样本来源（医疗机构其他就诊者检测比羁押人员：HR=1.584,95%CI=1.283~1.955）、抗病毒治疗（未接受ART比接受ART：HR=17.159,95%CI=15.062~19.547）、首次CD4细胞值（CD4为200~<350个/μL比<200个/μL：HR=0.536, 95%CI=0.459~0.627;350~<500个/μL比<200个/μL：HR=0.390,95%CI=0.323~0.472;≥500个/μL<200个/μL：HR=0.350,95%CI=0.286~0.427）。结论 在云南防治艾滋病政策和措施不断完善的背景下,保山31年来HIV/AIDS病人生存率得到较大提升,但男性、确诊年龄大、异性性途径传播、样本来源为医疗机构其他就诊者检测、未接受抗病毒治疗和首次CD4结果低是HIV/AIDS生存的危险因素,需要进一步精准防控。     

孕妇HIV疾病状况与新生儿LBW的相关性

  目的  分析HIV阳性孕妇所生新生儿的低出生体重（low birth weight，LBW）情况及其相关的危险因素。  方法  选择2013年1月至2018年5月于昆明市第三人民医院住院分娩的194例HIV阳性孕妇为研究对象。孕妇信息包括人口特征、妇产科病史、抗逆转录病毒药物史、HIV传播途径以及HIV疾病状况（包括入组时的CD4计数、HIV RNA病毒载量和血红蛋白）。采用Logistic回归分析确定与LBW相关的危险因素。  结果  在194名婴儿中，38例（19.6%）为LBW（< 2500 g）。LBW婴儿与非LBW婴儿在入组体重、怀孕期间抗逆转录病毒药物治疗、入组CD4计数、入组HIV RNA病毒载量和分娩时孕龄差异均有统计学意义（P < 0.05）。多变量Logistic回归分析显示，入组时体重轻（OR = 2.14，95% CI = 0.84～4.05，P = 0.013）、入组时CD4计数（OR = 6.02，95% CI = 1.50～24.13，P < 0.001）、入组时HIV RNA病毒载量（OR = 3.34，95% CI = 1.70～6.55，P < 0.001）和分娩时孕龄（OR = 12.90，95% CI = 2.03～81.88，P < 0.001）是LBW的独立危险因素。  结论  孕妇HIV疾病状况与新生儿LBW相关。HIV的产前筛查和诊断，对于早期预防和治疗HIV母婴传播，减少不良妊娠结局至关重要。