中国某地区人类免疫缺陷病毒母婴传播与阻断的调查研究  

The investigation of mother-to-child transmission of Type-1 Human Immunodeficiency Virus

作　　者：邓莉平[1] 桂希恩[1] 庄柯[2] 苏擘[2] 宁宜云[1] 姜友枝[1] 

机构地区：[1]武汉大学中南医院感染科,湖北430071 [2]武汉大学生命科学院

出　　处：《中华传染病杂志》2005年第3期183-186,共4页Chinese Journal of Infectious Diseases

摘　　要：目的了解人类免疫缺陷病毒在血源性艾滋病流行地区的母婴传播情况,分析影响传播的因素并提出对策。方法现场询问调查和常规体检并采静脉血,检测血清抗-HIV及HIV的前病毒DNA或RNA,分析母亲及其子女配对的资料,回顾性分析HIV的母婴传播。结果107例HIV阳性母亲生育的136名子女中,50例HIV阳性,HIV的母婴传播率为36.8%(50/136)。38例经血感染HIV阳性育龄妇女的外周血基因组核酸扩增HIV前病毒DNAgag区,鉴定均为HIVB′亚型。两对HIV阳性的母婴的外周血核酸扩增HIVgag区P17的片段,Mega软件分析其基因同源性,分别为95.0%、94.9%。基因树显示子女的病毒与其母亲同属一支。艾滋病状态母亲组HIV母婴传播率为67.4%(31/46)显著高于HIV携带状态母亲组的21.1%(19/90),P<0.05。奈韦拉平(NVP)阻断的7例儿童,6例未被HIV感染,1例感染HIV。结论被调查地区HIV母婴传播是儿童感染HIV的主要途径。未采取干预措施是造成传播的主要原因。NVP阻断母婴传播较易被接受并可能减少母婴传播。Objective To investigate mother-to-child transmission of HIV-1 and the factors that affect transmission. Methods 136 children who were born to HIV positive mothers in a high HIV prevalence region were interviewed and blood samples were examined for anti-HIV anti-HGV and HIV RNA or HIV DNA. Results Among 136 children who were born to HIV positive mothers, 50 were infected with HIV. The MTCT rate was 36.8% （50/136）. Thirty eight DNA fragments of HIV-1 gag gene P17 obtained from HIV-1 seropositive mothers were amplified by PCR from uncultured peripheral blood mononuclear cells （PBMCs）. Sequence analyses showed that all of them were HIV-1 B subtype. The HIV vertical transmission rate among mothers with AIDS （67.4%, 31/46） was significantly greater than among those with HIValone （21. 1%, 19/90）, P〈0.05. Nevirapine was given to seven HIV positive pregnant women at the onset of labor and their babies after delivery. All babies were fed formula exclusively. Six were not infected with HIV, one was infected with HIV. Conclusions The mother to child transmission rate of HIV-1 was 36.8% in the absence of MTCT prevention interventions. Nevirapine plus formula feeding and co-infection with HGV may reduce the MTCT rate of HIV-1.

关 键 词：HIV感染 艾滋病 儿童 疾病传播 垂直 肝炎 病毒性 人 中国 人类免疫缺陷病毒 阻断母婴传播 血清抗-HIV 前病毒DNA 

分 类 号：R512.91[医药卫生—内科学] R512.620.3[医药卫生—临床医学]