新疆伊宁市孕妇HIV流行情况及KABP调查

目的 了解伊宁市孕妇的HIV感染情况。方法2000年4月～2001年1月对在伊宁市妇幼保健院妇产科产前体检的孕妇进行问卷调查,同时进行HIV抗体检测。结果 共调查507名孕妇,查出HIV感染者1人,感染率为0.2％。随着文化程度的增高被调查孕妇对艾滋病的知晓率上升（趋势性检验x2=45.75,P<0.01）。文化程度越高对艾滋病知识的需求更高（趋势性检验x2=13.95,P<0.01）。孕妇认为产前应该进行艾滋病病毒检测的占 88.2％（447/507）。结论 伊宁市 HIV已从高危人群波及到一般人群,夫妻间性传播可能是新疆伊宁市孕妇感染HIV的主要途径。在HIV感染率高的地区对孕妇进行艾滋病知识宣传并开展产前HIV抗体检测势在必行。     

A study of immunoprophylaxis failure and risk factors of hepatitis B virus mother-to-infant transmission

Hepatitis B virus (HBV) infection is of high prevalence in China. Mother-to-infant transmission is the major route for HBV transmission and subsequent chronicity. This study aimed to investigate current HBsAg-positive rate among pregnant women and immunoprophylaxis outcome in China. Multicenter prospective study was conducted in 10 centers. From 2008 to 2012, 67,720 pregnant women were screened and 1,150 HBsAg-carrier mothers and their infants aged 8–12 months were studied in four out of all centers, among whom HBV markers (HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb) and HBV DNA (in three centers) were measured. The results showed that HBsAg-positive rate of pregnant women was 6.7 % (4,533/67,720) and infants’ immunoprophylaxis failure rate was 3.4 % (39/1,150). Immunoprophylaxis failure infants were all born to mothers of HBeAg-positive and HBV DNA ≥6 log₁₀?copies/ml. Among infants of HBeAg-positive mothers, multivariable analyses showed the following: mother’s age <28 years vs ≥28 years, RR?=?0.157, 95 % confidence interval (CI) [0.067, 0.369], p?=?0.000; Neonates receiving vaccine vs vaccine plus hepatitis B immune globulin (HBIG), RR?=?0.371, 95 % CI [0.167, 0.825], p?=?0.015. Pregnant women receiving HBIG in the third trimester, vaginal delivery and breastfeeding had no significant effects on HBV mother-to-infant transmission. Conclusions: Pregnant women are still of high HBsAg prevalence in China. HBV mother-to-infant transmission still occurs after passive-active immunization. Pregnant women of high HBV replication levels are the major risk population of HBV mother-to-infant transmission. Passive-active immunization is necessary for neonates of HBeAg-positive mothers. Mother’s age <28 years and neonate receiving vaccine only were the risk factors for HBV mother-to-infant transmission. Breastfeeding did not put children at risk of mother-to-infant transmission.