不同干预措施预防艾滋病母婴传播的效果研究  

Effectiveness of different interventions to prevent HIV/AIDS mother-to-child transmission

作　　者：孙定勇[1] 王奇[1] 樊盼英[1] 聂玉刚[1] 李宁[1] 朱谦[1] 王哲[1] 

机构地区：[1]河南省疾病预防控制中心,郑州450016

出　　处：《中国艾滋病性病》2016年第6期429-432,共4页Chinese Journal of Aids & STD

摘　　要：目的分析河南省对艾滋病病毒（HIV）感染孕产妇,采用不同干预措施预防母婴传播的效果。方法采用随访研究的方法,利用国家预防母婴传播干预（PMTCT）管理信息网络直报系统,以2004年1月至2012年12月确诊报告的863例HIV-1感染孕产妇及其所分娩的婴儿为研究对象,收集和整理孕产妇接受抗反转录病毒药物、安全助产和婴儿喂养指导等预防艾滋病母婴传播干预措施的实施服务情况,收集HIV感染孕产妇定期随访和婴儿的检测信息,掌握婴儿的HIV感染状态,分析干预措施对HIV母婴传播效果的影响。结果 HIV感染孕产妇所生的863名婴幼儿中,有47名感染HIV,艾滋病母婴传播率为5.45%。对不同方案的药物干预措施进行比较,联合、单一和未应用抗病毒药物的孕产妇,其母婴传播率分别为2.02%、3.16%、14.93%。在市、县、乡及以下助产机构分娩的感染孕产妇的母婴传播率分别为2.56%、4.44%和20.31%。孕早期（〈12孕周）接受艾滋病咨询检测服务的产妇,其母婴传播率低于孕中晚期（≥12孕周）产妇（3.08%、6.47%）（χ2=4.63,P〈0.01）,人工喂养婴儿发生母婴传播率低于非人工喂养婴儿（4.84%、14.04%）（χ2=7.05,P〈0.01）。多因素分析表明,产妇孕早期接受艾滋病咨询检测服务[比值比（OR）=0.24,95%可信区间（CI）：0.02-1.98],产妇孕早期服用抗病毒药物（OR=0.25,95%CI：0.09-0.69）、使用联合用药方案（OR=0.07,95%CI：0.02-0.28）、婴幼儿采取人工喂养（OR=0.16,95%CI：0.07-1.03）,是PMTCT的保护因素。结论艾滋病母婴传播的不同干预措施有效降低了艾滋病母婴传播水平。Objective To study the effectiveness of different interventions to prevent HIV/AIDS mother-to-child transmission.Methods Data of the pregnant women and infants were collected from the national management information web-based reporting system between 2004 and 2012,and analyzed by non-conditional logistic regression model.Results 863 infants born to HIV infected women were reported in Henan province from 2004 to 2012and among them 47 infants were HIV-infected,with the incidence of 5.45%.Effectiveness of drug interventions showed different rates of HIV mother to child transmission including 2.02%intervened by drug combination,3.16% by single drug,and 14.93% by no drug.The rates of HIV mother-to-child transmission were different at different levels of medical institutions where childbirth was given in the city（2.56%）,county（4.44%）,and township（20.31%）.The women in the early pregnancy（〈12weeks）receiving HIV counseling and testing services had 3.08% of HIV mother to child transmission,lower than those in late pregnancy women（≥12weeks）,accounting for 6.47%（χ2=4.63,P〈0.01）.The rate of artificial feeding had lower rate（4.84%）than rates of other feeding patterns（14.04%）（χ2=7.05,P〈0.01）.Multiple factor analysis showed that VCT in early pregnancy（OR=0.24,95%CI0.07-1.98）,standardized ARV regimen in early pregnancy（OR=0.25,95%CI 0.09-0.69）,drug combination（OR=0.07,95%CI 0.02-0.28）,artificial feeding（OR=0.16,95%CI 0.07-1.03）were the main protective factors to prevent HIV mother to child transmission.Conclusion The rate of HIV mother-to-child transmission can be reduced effectively after the intervention.

关 键 词：艾滋病母婴传播 感染孕产妇 干预措施 影响因素 

分 类 号：R512.91[医药卫生—内科学]