2009-2018年深圳市HIV阳性孕产妇特点及母婴阻断效果分析  

Characteristics of HIV-positive pregnant women and effect of prevention of mother-to-child HIV transmission in Shenzhen from 2009 to 2018

作　　者：田一梅[1] 梁梅馨 宋俊敏[2] 杨峥嵘[2] 周洁 王红[3] 包明稳[1] 王辉[1] TIAN Yimei;LIANG Meixin;SONG Junmin;YANG Zhengrong;ZHOU Jie;WANG Hong;BAO Mingwen;WANG Hui(Shenzhen Third People's Hospital,Shenzhen 518000,China;Shenzhen Center for Disease Control and Prevention,Shenzhen 518000;Maternal and Child Health Hospital of Shenzhen,518000)

机构地区：[1]深圳市第三人民医院感染一科,广东深圳518000 [2]深圳市疾病预防控制中心,广东深圳518000 [3]深圳市妇幼保健院,广东深圳518000

出　　处：《中国艾滋病性病》2020年第3期264-267,共4页Chinese Journal of Aids & STD

基　　金：国家科技重大专项(2017ZX10201101-001-009);深圳市卫生系统科研项目资助(20161033)。

摘　　要：目的了解近10年深圳市艾滋病病毒(HIV)阳性孕产妇的基本情况,观察临床母婴阻断效果。方法回顾性分析2009-2018年有分娩活产婴儿的HIV阳性孕产妇临床资料,总结HIV阳性孕产妇临床基础资料、母婴阻断等情况,观察10年来深圳市HIV阳性孕产妇妊娠及婴幼儿(0~24月龄)结局。结果 2009-2018年深圳市共上报288例HIV阳性孕产妇,平均年龄为(26.40±2.66)岁,发现HIV阳性时间为(15.36±10.12)孕周,95.49%(275/288)为性接触传播,以龙岗区和宝安区居多,地域差异较为明显。HIV阳性孕产妇产前抗病毒治疗(ART)率近10年来呈整体上升趋势。婴儿预防性抗病毒药物以齐多夫定、奈韦拉平以及二者联合为主,婴儿预防性抗病毒用药率也居于较高水平。10年来深圳市HIV阳性孕产妇产后共发现2例婴儿早期诊断阳性,抗病毒干预失败,并因机会性感染死亡。HIV阳性孕产妇母婴阻断成功率为99.31%(286/288),传播率仅为0.69%(2/288)。结论深圳市预防艾滋病母婴传播干预策略取得显著效果,母婴传播率远低于世界卫生组织制定的<2%的目标。Objective To observe the characteristics of HIV-positive pregnant women in Shenzhen and the effect of prevention of mother-to-child HIV transmission. Methods The clinical data of HIV-positive pregnant women with live births were analyzed retrospectively from 2009 to 2018, according to their basic clinical information, prevention of mother-to-child transmission each year, maternal health in pregnancy and neonatal outcomes. Results A total of 288 HIV-positive pregnant women were reported during the period in Shenzhen, with the mean age of 26.40±2.66 years, and the mean diagnosed time of 15.36±10.12 weeks. 95.49% were sexually transmitted. HIV-positive pregnant women were mostly located in the districts of Longgang and Baoan, with obvious geographical differences. The ART rate of HIV positive pregnant women before delivery was on the rise in the last ten years. AZT, NVP and AZT+NVP were the main antiretroviral drugs for infants and the rate of prophylactic antiviral drugs for infants was also at a high level. Only two cases of newborns diagnosed HIV positive failed in antiviral intervention, and died due to opportunistic infection. The successful prevention rate of mother-to-child HIV transmission was 99.31%(286/288), and the transmission rate was only 0.69%(2/288). Conclusion Shenzhen has achieved remarkable progress in prevention of mother-to-child transmission of HIV/AIDS, with the transmission rate of 0.69%, which is far below the target of < 2% set by the World Health Organization.

关 键 词：艾滋病病毒 阳性孕产妇 母婴阻断 

分 类 号：R512.91[医药卫生—内科学] R373.9[医药卫生—临床医学]