中国部分地区HIV阳性孕产妇的调查分析

目的:了解我国部分地区育龄妇女感染人类免疫缺陷病毒(HIV)的情况;调查研究各种阻断方式的效果,探讨适合我国国情的HIV母婴阻断措施。方法:2004年至2007年间,选择我国部分地区为调查地点,对来院进行孕检的妇女及孕期未曾检测HIV住院分娩的产妇进行HIV抗体筛查检测;对HIV阳性孕产妇采取相应阻断措施,此后追踪检测HIV母婴传播状况,综合分析各阻断方案的效果。结果:共筛查119616例孕产妇,检测HIV阳性65例,阳性率0.05%。65例阳性孕产妇中终止妊娠24例,分娩40例,待产1例;孕期、产时及产后发现的HIV阳性孕产妇分别占60.0%、15.4%及24.6%;性途径感染44例(67.7%),血途径感染21例(32.3%),以性传播途径为主;采取完全阻断措施20例(50.0%),1例HIV(+);不完全阻断措施15例(37.5%),1岁内死亡3例,失访2例;未实施阻断5例(12.5%),3例死产,1例HIV(+)。结论:孕产期做好HIV的自愿检测,有利于预防艾滋病母婴传播及阻断工作的开展,根据疫情不同,筛检措施应因地制宜;目前我国部分地区艾滋病流行以性传播为主;HIV母婴阻断应提倡早期发现早期预防,以免错过接受阻断传播的最佳时机;当前预防HIV母婴传播的策略降低了传播率,但也存在一些问题。

The incidence of HIV vertical transmission in some areas of China

Objective:To determine the incidence of HIV vertical transmission in a high HIV incident region in some areas of China;to analyze the effect of different anti-plan measures and the factors that influence acquired HIV infection;and to develop an appropriate treatment for preventing maternal to child transmission of HIV.Methods:From 2004 to 2007,the pregnant women were interviewed and blood samples were collected from both the mothers and children.HIV ELISA testing was performed on all samples and HIV subtyping was performed on the blood samples from the HIV infected women.HIV-Ab testing was performed on all OB physician-nurse teams.Subtyping of a subset of HIV infected pregnant women and non-pregnant women was performed.HIV infected pregnant women showed different sub-strategy.The different plans of the anti-effect were analyzed.Results:Altogether 119,616 pregnant women were examined,65 pregnant women were infected with HIV,among them,24 were stopped the pregnancy,40 labored,1 was treating.And 44 women were infected with HIV by sexual transmission,21 were by blood transmission.35 HIV infected women showed MTCT prevention interventions,5 being in the absence of MTCT prevention interventions.Conclusion:Without treatment,the mother to child transmission rate of HIV is high.Sexual transmission is the main transmitting way in these areas of China.According to different situation screening measures should be different.MTCT prevention interventions may reduce the MTCT rate of HIV-1.