HIV暴露未感染儿童预防性用药对其体格生长发育的影响

目的 了解广州市HIV暴露未感染（HEU）儿童预防性用药对其体格生长发育的影响。方法 数据来自国家“预防艾滋病、梅毒和乙肝母婴传播管理信息系统”实时监测收集的广州市HIV感染孕产妇及其所生儿童检测治疗与随访等信息，剔除婴儿死亡及感染HIV个案，共纳入564例HEU儿童。HEU儿童预防性用药方案分为3种情况：奈韦拉平（NVP）、齐多夫定（AZT）和未用药，采用广义估计方程等方法分析HEU儿童预防性用药对其体重、身长等的影响。结果 HEU儿童1月龄时，年龄别体重Z分、年龄别身长Z分略低于WHO的参考标准，服用AZT组消瘦发生率（17.5%）高于服用NVP组（6.2%）。儿童预防性服用NVP或AZT是HEU儿童年龄别身长Z分的保护因素，宫内暴露三联抗病毒药物是HEU儿童年龄别体重Z分、年龄别身长Z分的危险因素（P<0.05）。结论 1月龄HEU儿童体格生长发育状况欠佳，服用AZT的HEU儿童满月时消瘦发生率更高，应重点关注。

Influence of antiretroviral prophylaxis on growth of HIV-exposed uninfected infants

Objective To evaluate the influence of antiretroviral prophylaxis on the growth and development of HIV-exposed uninfected infants in Guangzhou. Methods Data were from the national information system for prevention of mother-to-child transmission of HIV infection, syphilis and hepatitis B. After excluding death and perinatal HIV infection cases, 564 HIV-exposed uninfected infants were included. The infants were divided into three groups, nevirapine (NVP) group, zidovudine (AZT) group and untreated group. The influences of antiretroviral prophylaxis on the body weight and height of the HIV-exposed uninfected infants were analyzed by using generalized estimating equations. Results The HIV-exposed uninfected infants at 1-month old had lower Z scores of body weight-for- age and body height-for-age than the World Health Organization''s reference standard. The prevalence of wasting in AZT group (17.5%) was higher than that in NVP group (6.2%) for 1-month old infants. Taking NVP or AZT was a protective factor for Z score of body length-for-age (P<0.05). Intrauterine exposure to triple antiviral drugs was a risk factor for the Z scores of body weight-for-age and body length-for-age (P<0.05). Conclusion The physical growth and development of HIV-exposed uninfected infants at 1-month old was not well, and HIV-exposed uninfected infants who taking AZT had a higher incidence of wasting. Attention should be paid to these infants.