河南省2002—2014年预防艾滋病母婴传播干预工作效果研究  

Effectiveness evaluation on prevention of mother-to-child transmission of HIV in Henan province,2002—2014

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

机构地区：[1]河南省疾病预防控制中心性病艾滋病防治研究所,河南郑州450016

出　　处：《河南医学研究》2017年第9期1537-1540,共4页Henan Medical Research

基　　金：国家"十二五"科技重大专项(2012ZX10004905)

摘　　要：目的了解2002—2014年河南省预防艾滋病母婴传播干预工作的效果。方法对HIV感染产妇及其分娩婴儿进行随访,收集不同年度干预措施实施情况及分娩婴儿的生存感染状况,分析不同干预措施对艾滋病母婴传播的影响,采用非条件Logistic回归探索艾滋病母婴传播的有关因素。结果截止2014年12月31日,共对10 208 941名孕产妇提供HIV检测咨询,发现HIV感染孕产妇2 428人,HIV检测阳性率为0.024%,孕产妇HIV检测阳性率呈现逐年递减趋势(χ~2=4.88,P=0.027)。分娩的1 673名婴儿中,有1 515人存活且满18月龄,已经死亡儿101人,失访57人。1 515名婴儿中阳性60人,阴性1 324人,存活婴儿HIV母婴传播率为4.22%,校正死亡后HIV母婴传播率为6.25%。干预措施中产妇药物阻断率为76.96%,婴儿药物阻断率为92.5%,孕早期接受HIV检测率为70.5%。多因素分析显示,孕早期接受预防艾滋病母婴传播服务(OR=0.23,95%CI:0.07~0.72),抗病毒药物阻断(OR=0.46,95%CI:0.23~0.95),婴幼儿采取人工喂养(OR=0.09,95%CI:0.02~0.35)是艾滋病母婴传播的保护因素,产妇分娩过程采取侧切操作(OR=3.52,95%CI:1.49~8.27)是其危险因素。结论河南省预防艾滋病母婴传播综合干预措施比较完善,孕产妇HIV检测阳性率保持在较低水平,但HIV暴露婴儿的母婴传播率及婴儿死亡率较高,应有针对性地加强综合干预措施。Objective To evaluate the effectiveness of the interventions on preventing mother - to - child transmission of HIV, and explore the influencing factors. Methods The data regarding the pregnant and infants were collected, including de- mographic characteristics, antiviral therapy, HIV infections of infants between 2002 and 2014 through follow -up. Multivariate logistic regression model was used to explore the influencing factors. Results By the end of the year 2014, 10 208 94 pregnant accepted the service of HIV test, 2 428 cases were infected by HIV, and the positive rate of HIV was 0. 024%. The HIV tested positive rate decreased year by year （P =0. 027）. Among 1 673 infants reported from 2002 to 2014, 1 515 infants survived for more than month one and a half years, 101 infants were dead, and 57 were lost of follow up. 64 infants were tested HIV - posti- tive, and 1 451 infants were tested HIV - negative. The MTCT rate was 4. 22% , the corrective MTCT rate was 6. 25%. Drug blockade rates of puerperae and infants were 76. 96% and 92. 5% respectively. The detection rate of HIV in early pregnancy was 70. 5%. Accepting the services in early pregnancy （OR =0. 23, 95% CI： O. 07 -0. 72）, standardized antiviral therapy （OR = 0. 46, 95% Cj=O. 23 - 0. 95 ） , artificial feeding （ OR = 0. 09, 95% CI： 0.02 - 0. 35 ） may be the main protective factors, and episiotomies on delivery （ OR = 3.52, 95% CI： 1.49 - 8. 27） may be the risk factors. Conclusion The HIV transmission of mother to child and mortality is higher. It is necessary to increase quality of services to the HIV pregnant and infants.

关 键 词：艾滋病 母婴传播 婴幼儿 影响因素 

分 类 号：R512.91[医药卫生—内科学]