中国部分地区艾滋病病毒1型母婴传播回顾性追踪调查  

An investigation on HIV-1 transmission from mothers to children in selected areas of China

作　　者：李关汉[1] 梅珊[1] 魏飞力[1] 冯鑫[1] 曹韵贞[1] 程何荷[2] 何云[3] 顾丽芳[3] 孙峰 周曾全[5] 杨欣平 段松 段一娟 王世一[8] 佟伟 

机构地区：[1]中国疾病预防控制中心性病艾滋病预防与控制中心临床病毒研究室,北京100050 [2]云南省卫生防疫站 [3]河南省郑州市第六人民医院 [4]新疆维吾尔自治区伊犁哈萨克自治州卫生防疫站 [5]云南省昆明市传染病医院 [6]云南省德宏傣族景颇族自治州卫生防疫站 [7]云南省瑞丽市卫生防疫站 [8]云南省昆明市卫生防疫站 [9]辽宁省大连市卫生防疫站

出　　处：《中国性病艾滋病防治》2002年第4期204-207,215,共5页Chinese Journal of Std & Aids Prevention and Control

摘　　要：目的 了解中国艾滋病病毒1型(HIV-1)母婴传播的现状,特别是母婴传播的发生率和影响因素,为进一步开展预防阻断工作提供背景资料。方法 以地方卫生防疫和医疗机构的哨点监测、产前筛查、日常检测和门诊中发现的HIV-1阳性孕产妇为对象,对其所生子女进行追踪调查和检测。结果 对来自云南、河南、新疆等10个省(自治区、直辖市)的87例HIV-1阳性母亲所生的94名儿童进行追踪,最后追踪到75例母亲及其所生的80名儿童,HIV-1母婴传播发生率为35.0％(28/80)。而河南省的母婴传播率为41.7％(10/24),云南省和新疆维吾尔自治区分别为33.3％(11/33)和27.3％(3/11)。对相关影响因素的分析发现,母亲的感染途径、生产胎次和喂养方式对HIV-1母婴传播有一定的影响作用,其中输血传播、初产和母乳喂养是高危因素。相应的母婴传播率分别为45.5％、39.2％和36.2％,而性传播、多胎生产及人工喂养分别为32.1％、25.9％和22.2％,但差异无显著统计学意义。结论 该研究表明,中国HIV-1母婴传播率与亚非发展中国家相似,而高于西方发达国家。对相关的高危因素(如孕妇的感染途径,特别是输血传播)有必要作进一步地研究。Objective To investigate the incidence of HIV-1 transmission from mothers to children in China and the risk factors. Methods The children bom to HIV positive mothers who had been registered in health institutions or detected in hospitals, were followed up retrospectively and requested to test HIV viral load or antibodies.Blood or urine samples were tested by bDNA assay or both ELISAand Westernblot assay.Results A total of 94 children born to 87 HIV- 1 positive mothers were included in this cohort, who were distributed over 10 provinces or autonomous regions, including Yunnan, Henan, Xinjiang and Guangdong, and 80 children born to 75 mothers were completed to investigate and test for HIV RNA or antibodies.The overall rate of HIV- 1 transmission from mother to child was 35.0% (28/80) (95%C1:24.6%-45.4% ), and41.7% (10/24) were reported in Henan, where HIV-1 spreaded overwhelmingly by illegal blood transfusion in the early 1990's,and 33.3% (11/33) and 27.3% (3/11) were reported in Yunnan and Xinjiang respectively, where HIV epidemic dominated in intravenous drug users. The factors influencing HIV mother - to - child transmission were simultaneously investigated in this study, such as mother' s infection routes, delivery modes, delivery times and feeding practices. The rates of transmission related with mottles' blood transfusion, sexual behaviors, primiparous and multiparows deliveries, breast feeding and feeding with formula were 45. 5% (10/22), 32.1% (17/53(, 25.9(7/27), 36.2% (25/69) and 22.2% (2/9), respectively.but no statistical difference was found in each group of these relateel factors. Conclusion The rates of HIV - 1 transmission from mothers to children in China are higher than those in western countries and similar to these in African and Asian countries, and the risk cacters should be studied further.

关 键 词：中国 艾滋病 艾滋病病毒1型 母婴传播 调查 发生率 影响因素 

分 类 号：R512.91[医药卫生—内科学]