河南省HIV母婴传播的影响因素分析

目的 了解河南省HIV母婴传播情况,分析HIV母婴传播的危险和保护因素.方法 通过国家预防艾滋病母婴传播信息管理系统,收集2002-2013年HIV感染孕产妇及所分娩婴幼儿的有关干预信息,包括孕产妇HIV检测咨询、围产期保健服务、抗病毒药物阻断、婴幼儿随访检测等情况,采用非条件logistic回归对HIV母婴传播的影响因素进行分析.结果 截至2013年12月底,共有1 384例婴幼儿存活至18月龄,检测阳性婴幼儿60人,检测阴性婴幼儿l 324人.存活婴幼儿累计母婴传播率4.34％,存活婴幼儿分年度母婴传播率无明显降低趋势(X2=2.82,P=0.093).产妇孕早期接受预防HIV母婴传播服务(0R=0.22,95％ C.I.0.06～0.77),产妇及婴幼儿进行抗病毒药物阻断(0R=0.46,95％C.I.0.21～0.91),婴幼儿采取人工喂养(OR=0.08,95％ C.I.0.02～0.30)是HIV母婴传播的保护因素,产妇分娩过程采取侧切操作(0R=3.17,95％ C.I.1.37～7.36)是其危险因素.结论 河南省存活婴幼儿HIV母婴传播率较高,应针对主要影响因素一步完善预防HIV母婴传播的综合干预措施.

Risk factors associated with Mother-to-child transmission of HIV in Henan province

Objective To investigate the situation of the mother-to-child transmission of HIV in Henan province so as to explore the risk and protective factors.Methods The data regarding HIV-infected pregnant women and their infants from 2002 to 2013 were collected from (national notifiable disease reporting system),including PITC,perinatal health service,ART and follow-up examination for infants.Univariate and multivariate logistic regression model were used to explore the influencing factors.Results A total of 1 384 infants survived to 18 months old,including a 60 HIV-positive infants and 1 324 HIV-negative infants.The MTCT rate was 4.34％ which did not show significant decreasing from 2002 to 2013 (χ2=2.82,P=0.093).VCT in early pregnancy (0R=0.22,95％ C.I.0.06～0.77),standardized ARV regimen in early pregnancy (0R=0.46,95％ C.I.0.21～0.91),artificial feeding (0R=0.08,95％ C.I.0.02～0.30) may be the main protective factors;episiotomies on delivery (0R=3.17,95％ C.I.1.37～7.36) may be the risk factors.Conclusions The MTCT rate is higher in Henan province,and the targeted interventions of MTCT should be further improved.