2002-2014年河南省HIV暴露婴幼儿母婴阻断效果研究  

The effectiveness study on mother-to-child transmission of HIV-exposed infants in Henan province from 2002 to 2014

作　　者：王奇[1] 孙定勇[1] 司珩[1] 樊盼英[1] 聂玉刚[1] 马彦民[1] 李宁[1] 王哲[1] 

机构地区：[1]河南省疾病预防控制中心,河南郑州450016

出　　处：《现代预防医学》2017年第8期1499-1502,1510,共5页Modern Preventive Medicine

基　　金：河南省医学科技攻关计划项目(201602308);国家"十二五"科技重大专项(2012ZX10004905)

摘　　要：目的了解不同时期河南省HIV暴露婴幼儿母婴传播及生存情况,分析母婴传播的有关因素。方法通过预防艾滋病、梅毒及乙肝母婴传播信息系统,收集不同工作时期HIV感染孕产妇及所分娩婴儿的有关干预信息,包括孕产妇围生期母婴阻断服务、婴幼儿HIV感染及生存状况等,采用Logistic回归对影响HIV母婴传播的有关因素进行分析。结果截止2014年12月底分娩的1 673例婴幼儿中,存活满18月龄婴儿共1 515人(90.56%),其中检测阳性婴儿64人(3.83%),检测阴性婴儿1 451人(86.73%),已经死亡的婴儿101人(6.04%),失访婴儿57人(3.40%),婴儿累计死亡率为6.24%,存活婴儿累计母婴传播率为4.22%,校正累计艾滋病母婴传播率6.25%。产妇孕早期接受PMTCT服务(OR=0.23,95%CI:0.07~0.72),产妇及婴儿药物阻断(OR=0.46,95%CI:0.23~0.95),婴幼儿采人工喂养(0R=0.09,95%CI:0.02~0.35)是艾滋病母婴传播的保护因素,产妇分娩过程不安全助产(0R=3.52,95%CI:1.49~8.27)是其危险因素。结论艾滋病暴露婴幼儿的母婴传播率及死亡率均较高,应进一步加强孕产妇及婴儿的随访管理,同时进一步完善预防艾滋病母婴传播的综合干预措施。Objective The aim of this study was to evaluate the effectiveness of the interventions on preventing mother-to- child transmission of HIV, in order to explore the influencing factors. Methods The data regarding the pregnant and infants were collected from national notifiable disease reporting system between 2002 and 2014,including the PMTCT service in the period of perinatal stage, HIV infection and living situation of infant etc. Univariate and multivariate logistic regression models were used to explore the influencing factors. Results A total of 1673 infants were reported from 2002 to 2014. 1515 infants were one and a half years old. 64 infants were tested HIV-positive. 1451 infants were tested HIV-negative. 101 infants were dead. 57 were lost in the follow up. The MTCT rate was 4.22%. The corrective MTCT rate was 6.25%. VCT in early pregnancy （OR=0.23,95% CI：0.07-0.72）, standardized ARV regimen in early pregnancy （0R=0.46,95%CI：0.23-0.95）, artificial feeding （OR=O.O9,95%Cl：O.O2-O.35）may be the main protective factors. Episiotomies on delivery （0R=3.52,95%CI： 1.49-8.27）may be the risk factors. Conclusion The rate of mother-to-child transmission and mortality of HIV-exposed infants were both high.It is necessary to increase quality of services to the HIV pregnant women and infants.

关 键 词：艾滋病 母婴传播 婴幼儿 影响因素 

分 类 号：R183[医药卫生—流行病学]