孕14周高效抗逆转录病毒疗法母婴阻断HIV感染疗效观察

目的:探讨孕14周应用高效抗逆转录病毒疗法(HARRT)对艾滋病病毒(HIV)感染的孕妇母婴阻断疗效。方法:选择2014年2月-2017年8月本院接受治疗的60例HIV感染孕妇作为研究对象,根据治疗时点的不同分为观察组和对照组各30例,两组均接受HARRT治疗,观察组于孕14周开始用药,对照组于孕28周开始用药。比较两组治疗前(T0)、预产期前1个月(T1)、产后3个月(T2)时CD4+T淋巴细胞、HIV病毒载量、分娩情况及母婴阻断效果。结果:两组不同时间点CD4+T淋巴细胞比较均有差异,观察组在T1、T2时点CD4+T淋巴细胞升高程度>30%的患者均高于对照组(P<0.05),而HIV病毒载量<50拷贝数/ml的患者两组比较无差异(P>0.05);两组剖宫产、早产、低体重儿、新生儿轻度窒息发生率无差异,婴儿HIV阳性率无差异(均P>0.05)。结论:孕14周应用HARRT可更好促进HIV感染的孕妇免疫功能重建,未见不良结局增加。建议临床应尽早开始治疗。

The effect of HARRT used from 14 gestational weeks for blocking maternal HIV infected infant

Objective:To explore the effect of high-performance antiretroviral therapy(HARRT)used from 14 gestational weeks for blocking maternal human immunodeficiency virus(HIV)infected infant.Methods:60 HIV-infected pregnant women were selectedin this study from February 2014 to August 2017.Among them,30 women in observation group were treated with HARRT from 14 gestational weeks,and 30 women in control group were treated with HARRT from 28 gestational weeks.The number of CD4+T lymphocyte and HIV viral load of women before treatment(T0),1 month before delivery(T1),and 3 months after delivery(T2)were compared between the two groups.The delivery status and clinical curative effect of HIV blockade between mother and infant were also compared between the two groups.Results:There was significant different in the number of CD4+T lymphocyte of women at T0,T1 and T2 between the two groups,and the women with the number of CD4+T lymphocyte increased over 30%at T1 or T2 in the observation group was significant more than that in the control group(P<0.05).There were no significant difference in the number of women with HIV viral load less than 50 copies/ml at T1 and T2,and rates cesarean section,premature delivery,low birth weight infants,and neonatal mild asphyxia between the two groups(P>0.05).Conclusion:HARRT used for maternal and infant blockade of HIV infected from 14 gestational weeks can promote the immune function reconstruction of pregnant women with HIV infected,and can increase the rate of maternal and infant blockade,which dosen’t increase the adverse pregnantcy outcomes.So it is suggested that HARRT shoule be clinical used as soon as possible.