HIV母婴阻断婴儿早期诊断及随访分析  

Early Diagnosis and Follow-up Analysis of HIV Mother-infant Blocking Infants

作　　者：王周菊 林菁 朱炜春 谭文争 马丙南 沈谏娣 王律[1] WANG Zhouju;LIN Jing;ZHU Weichun;TAN Wenzheng;MA Bingnan;SHEN Jiandi;WANG Lyu(Department of Pediatrics,Guangzhou Eighth People's Hospital,Guangzhou Medical University,Guangzhou Guangdong 510000,China)

机构地区：[1]广州医科大学附属市八医院儿科,广东广州510000

出　　处：《中国卫生标准管理》2022年第18期15-19,共5页China Health Standard Management

摘　　要：目的分析已规范母婴阻断治疗的人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染母亲所生婴儿的早期诊断结果及随访情况,为临床诊疗提供参考依据。方法选取广州医科大学附属市八医院2017年1月—2020年1月收治随访的108例HIV阳性孕产妇(孕期有规则服用三联抗病毒药物无中断)所生婴儿,所有婴儿出生后6 h均口服奈韦拉平混悬液或口服齐多夫定糖浆进行预防抗病毒治疗,持续6周;产后无异常者常规接种乙型肝炎疫苗,指导人工喂养。固定随访至18个月,分析婴儿出生1周内、出生后1个月、出生后3个月的HIV-1 RNA阴性率,以及出生后12个月、18个月的HIV抗体阴性率;部分18个月HIV抗体未转阴者,延长随访至出生后22~24个月。结果婴儿出生1周内、出生后1个月、出生后3个月的HIV-1 RNA阴性率均为99.07%;婴儿出生后12、18个月的HIV抗体阴性率分别为68.52%和96.30%。结论未感染的HIV母婴阻断婴儿不同个体间HIV-抗体转阴时间差别较大,最迟转阴时间可晚至出生后24个月,其HIV-1 RNA早期检测结果准确性较高,可达到早期诊断的目的。Objective To analyze the early diagnosis and followup of babies born to HIV-infected mothers who have standardized mother-to-child blocking treatment,and provide reference for clinical diagnosis and treatment.Methods Infants born to 108HIV-positive pregnant women(regularly taking triple antiviral drugs during pregnancy without interruption)who were admitted to Guangzhou Eighth People’s Hospital,Guangzhou Medical University,from January 2017 to January 2020 were selected.All infants were given nevirapine orally suspended 6 hours after birth Preventive antiviral treatment with liquid or oral zidovudine syrup for 6 weeks;routinely vaccinate hepatitis B vaccine for those who have no abnormalities after delivery,and guide artificial feeding.Regular follow-up to 18 months,analysis of HIV-1 RNA negative rate within 1 week of birth,1 month after birth,and 3 months after birth,as well as HIV antibody negative rate at 12 months and 18months after birth,partly the follow-up for those who have not turned negative for HIV antibody at 18 months was extended to 22 months to 24 months after birth.Results The HIV-1 RNA negative rate of babies within 1 week of birth,1 month after birth,and 3months after birth were all 99.07%;the HIV antibody negative rate of babies at 12 months and 18 months after birth was 68.52% and 96.30%,respectively.Conclusion There is a big difference in the time of HIV-antibody conversion between different individuals of uninfected HIV mothers and infants,and the latest conversion time can be as late as 24 months.The results of early HIV-1 RNA detection are more accurate and can achieve the purpose of early diagnosis.

关 键 词：HIV阳性 孕产妇 母婴阻断 抗病毒治疗 HIV-1 RNA HIV抗体 

分 类 号：R714[医药卫生—妇产科学]