我国艾滋病母婴传播水平传播时期及干预效果研究  

The rate and stages of HIV mother to child transmission in some areas of China with relatively high HIV/AIDS prevalence and evaluation of the effectiveness of relevant interventions

作　　者：王临虹[1] 方利文[1] 王前[1] 蒋岩[2] 龚双燕[1] 张麒[1] 张伟[3] 李燕[4] 孙定勇[4] 莫云[5] 

机构地区：[1]中国疾病预防控制中心妇幼保健中心,北京100013 [2]中国疾病预防控制中心性病艾滋病预防控制中心,北京100050 [3]新疆维吾尔自治区疾病预防控制中心妇幼保健中心,乌鲁木齐830002 [4]云南省妇幼保健院,昆明650051 [5]河南省疾病预防控制中心性病艾滋病防治研究所,郑州450003

出　　处：《中国艾滋病性病》2008年第5期435-438,共4页Chinese Journal of Aids & STD

基　　金：国家"十五"科技攻关课题资助(2004BA719A03)

摘　　要：目的了解我国部分艾滋病高流行地区艾滋病母婴传播水平、传播时期及预防艾滋病母婴传播干预措施的效果。方法在艾滋病病毒(HIV)感染相对高发的4个省15个县/市/区。于2004年12月至2007年6月,对287名确诊的艾滋病病毒Ⅰ型(HIV-1)感染孕产妇进行问卷调查及追踪管理,对其分娩的287名婴幼儿进行HIV-1 DNAPCR检测和HIV抗体检测。结果287名HIV-1感染孕产妇分娩的婴幼儿中。38名婴幼儿感染了HIV,艾滋病母婴传播总体水平为13.24%(38/287);未采取任何干预措施的孕产妇组艾滋病母婴传播水平为34.78%。规范应用抗逆转录病毒药物和采取人工喂养措施组的母婴传播率为4.48%,人群水平的总体母婴传播率从34.78%下降到13.24%,下降率为61.94%(x^2=7.82,P<0.01)。24例HIV感染婴幼儿可明确其发生艾滋病母婴传播的时期,37.50%(9/24)母婴传播发生在宫内,33.33%(8/24)发生在产时,29.17%(7/24)为产后经母乳喂养传播。结论预防艾滋病母婴传播干预措施能有效降低艾滋病母婴传播水平,应加强提供规范的预防艾滋病母婴传播干预措施,进一步降低母婴传播率。Objective To study the rate and stages of HIV mother to child transmission （MTCT） in some areas of China with relatively high HIV/AIDS prevalence and assess the effectiveness of relevant interventions. Methods Two hundred and eighty seven HIV-1 infected maternal women selected from 15 counties/cities/prefectures of 4 provinces with relatively high HIV/AIDS prevalence were interviewed and traced with questionnaires between December of 2004 and July of 2007, and their babies were tested for HIV-1 DNA with PCR and for HIV antibodies with ELISA within six months after birth. Results Of the tested 287 infants, thirty eight were infected with HIV-1. The overall MTCT rate in the whole study areas was 13.24 % （38/287）. The rate was 34.78 % （8/23） among the maternal women for whom no preventive interventions were adopted and it was 4.48 % （3/67） among the women who received standardized antiretroviral therapy and artificial feedings. And the overall MTCT rate dropped from 34.78% to 13.24% after the interventions, with a dropping rate of 61.49% （χ^2 = 7.82, P 〈 0.01）. By analyzing the stages of MTCT occurrence, it was found that 37.50% （9/24） of MTCT occurred in uterus, 33.33% （8/24） - during the intrapartum and 29.17% （7/24） - during the postpartum. Conclusion Interventions targeted to MTCT, or PMTCT could effectively reduce the risk of HIV infection, and PMTCT services should be enhanced with emphasis on raising their quality in order to reduce overall rate of MTCT.

关 键 词：艾滋病 母婴传播 传播水平 传播时期 干预效果 

分 类 号：R512.91[医药卫生—内科学]