2004-2023年湖北省人类免疫缺陷病毒感染孕产妇抗病毒治疗情况与影响因素分析  

Current status of antiviral treatment and influencing factors in human immunodeficiency virus-infected pregnant women in Hubei,2004−2023

作　　者：徐阳欢 张蕃[2] 王玉红[1] 戴琼[1] 李德海 尹丹丹 程凯 卢宇翾 代国红[1] Xu Yanghuan;Zhang Fan;Wang Yuhong;Dai Qiong;Li Dehai;Yin Dandan;Cheng Kai;Lu Yuxuan;Dai Guohong(Maternal and Child Health Hospital of Hubei Province,Wuhan 430070,Hubei,China;Hubei Province Center for Disease Control and Prevention,Wuhan 430079,Hubei,China)

机构地区：[1]湖北省妇幼保健院,湖北武汉430070 [2]湖北省疾病预防控制中心,湖北武汉430079

出　　处：《疾病监测》2025年第1期72-77,共6页Disease Surveillance

基　　金：中国疾病预防控制中心妇幼保健中心“2020年度合生元母婴营养与健康研究项目”(No.2020FYH008)。

摘　　要：目的探讨人类免疫缺陷病毒(HIV)感染孕产妇抗病毒治疗情况及主要影响因素,为进一步完善湖北省消除HIV母婴传播工作策略提供科学依据。方法收集2004年1月至2023年12月全国预防艾滋病、梅毒和乙肝母婴传播管理信息系统中湖北省报告的HIV感染孕产妇相关流行病学调查资料,采用趋势性χ^(2)检验和logistic回归模型,分析HIV孕产妇抗病毒治疗情况及其影响因素。结果761例HIV感染孕产妇平均年龄(28.64±5.40)岁,文化程度以初中学历为主(397例,52.17%),588例(77.27%)接受抗病毒治疗。2004—2023年湖北省HIV感染孕产妇抗病毒治疗率由45.65%上升至98.15%(趋势χ^(2)=123.667,P<0.001),孕早期治疗所占比例由2.38%上升至81.13%(趋势χ^(2)=140.126,P<0.001)。多因素分析显示,分娩年份为2016—2023年[调整后的比值比(aOR)=4.52,95%置信区间(CI):2.65~7.70]、高中及以上文化程度(aOR=2.39,95%CI:1.15~4.98)、孕期随访1~2次(aOR=2.67,95%CI:1.29~5.53)、孕期随访3~4次(aOR=3.77,95%CI:1.79~7.96)、孕期随访≥5次(aOR=6.48,95%CI:3.36~12.48)是HIV感染孕产妇抗病毒药物应用的促进因素(P<0.05);非本县(区)户籍(aOR=0.56,95%CI:0.33~0.93)以及产时/产后确认感染(aOR=0.07,95%CI:0.04~0.14)是HIV感染孕产妇抗病毒药物应用的危险因素(P<0.05)。结论湖北省HIV感染孕产妇抗病毒治疗情况的总体趋势向好,分娩时期、文化程度、户籍、随访次数和确认感染时期均是该人群接受抗病毒治疗的独立影响因素,应针对以上影响因素加强重点人群管理,规范落实母婴阻断干预服务,提高HIV感染孕产妇抗病毒治疗率。Objective To investigate the current status of antiviral treatment and influencing factors in human immunodeficiency virus(HIV)-infected pregnant women in Hubei province and provide evidence for the improvement of the strategy of eliminating mother-to-child transmission of HIV.Methods A retrospective analysis was conducted on the epidemiological data of HIV-infected pregnant women in Hubei from January 2004 to December 2023,which were collected from national information system of integrated prevention of mother-to-child transmission management.Univariate x test and logistic regression methods were used to analyze the current status of antiviral treatment and influencing factors in HIV-infected pregnant women in Hubei.Results A total of 761 HIV-infected pregnant women were reported in Hubei,their average age was 28.64±5.40 years.They usually had education level of junior high school or below(52.17%,397),and 588 of them(77.27%)received antiviral treatment.From 2004 to 2023,the antiviral treatment rate in HIV-infected pregnant women in Hubei increased from 45.65%to 98.15%(trend χ^(2)=123.667,P<0.001),and the treatment rate in early pregnancy increased from 2.38%to 81.13%(trend χ^(2)=140.126,P<0.001).The results of multivariate analysis showed that the childbirth year from 2016 to 2023[adjusted odds ratio(aOR)=4.52,95%confidence interval(CD):2.65-7.70],education level at or above senior high school(aOR=2.39,95%CI:1.15-4.98),1-2 follow-up visits during pregnancy(aOR=2.67,95%CI:1.29-5.53),3-4 follow-up visits during pregnancy(aOR=3.77,95%CI:1.79-7.96)and≥5 follow-up during pregnancy(aOR=6.48,95%CI:3.36-12.48)were the positive factors for the compliance of antiviral treatment in the HIV-infected pregnant women(P<0.05).Non-local residence(aOR=0.56,95%CI:0.33-0.93)and intrapartum/postnatal confirmed infection(aOR=0.07,95%CI:0.04-0.14)were the negative factors for the compliance of antiviral treatment in the HIV-infected pregnant women(P<0.05).

关 键 词：湖北省 孕产妇 人类免疫缺陷病毒 抗病毒治疗 影响因素 

分 类 号：R211[医药卫生—中医学] R512.91