艾滋病高发农村儿童人类免疫缺陷病毒感染与艾滋病发病的关系  

A survey of children with HIV/AIDS in highly epidemic villages of AIDS

作　　者：庄柯[1] 桂希恩[1] 骆嘉拉[1] 王晓榕[2] 苏擘[3] 张永喜[1] 

机构地区：[1]武汉大学中南医院感染科,430071 [2]武汉大学中南医院儿科,430071 [3]武汉大学生命科学院现代分子病毒研究室

出　　处：《中华儿科杂志》2003年第8期586-589,共4页Chinese Journal of Pediatrics

摘　　要：目的　了解艾滋病高发区儿童感染人类免疫缺陷病毒 (HIV)情况。方法　对某艾滋病高发农村高危育龄妇女及其年龄小于 15岁的子女进行现场询问调查和采静脉血作HIV检测。结果　 15 9名儿童中 37例HIV阳性 ,其中 33例为母婴途径感染 ,占 89 2 % ,3例经输血感染 ,占 8 1% ,其他途径感染 1例 ,占 2 7%。HIV母婴传播率为 38 4 % (33/ 86 )。艾滋病状态母亲组母婴传播率(6 8 8% ,2 2 / 32 )显著高于HIV携带状态组 (2 0 4 % ,11/ 5 4 ) ,P <0 0 5。 37名感染儿童中 12例发展成艾滋病 ,4例死亡 ,其中 2例死于结核。 33例中 31例造成母婴传播的HIV阳性妇女在孕产前未作HIV检测 ,占 93 9%。 8名妊娠期HIV阳性妇女 ,1例艾滋病病情加重 ,2例自然流产 ,2例经规劝终止妊娠 ,3例继续妊娠。结论　母婴传播是儿童感染HIV的主要途径。未对高危生育期妇女进行有效的HIV监测及咨询 ,未采取有效干预措施是造成儿童HIV/AIDS的主要原因。亟需采取相应的对策控制HIV进一步蔓延 ,保护AIDS高发区妇女及儿童的健康。Objective To estimate prevelance of HIV/AIDS among children and the transmission routes in a highly endemic villages of AIDS.Methods Totally 208 high-risk women of child bearing age and 159 of their children aged 0-14 years were investigated. Their medical histories of blood donation or transfusion were collected, blood samples were taken and sera were separated for HIV test. Enzyme-linked immunosorbent assay (ELISA) and Western blot assay were performed for HIV antibody. The Nested-polymerase chain reaction (PCR) assay amplifying gag gene p17 was performed on samples of children aged less than 18 months.Results Thirty-seven HIV infected cases were found among 159 children aged 0-14 years of whom 33 were infected by mother-to-child transmission (89.2%, 33/37), 3 by blood transfusion (8.1%, 3/37) and one by iatrogenic route (2.7%, 1/37). Sixty seven mothers who were seropositive for HIV and their 86 children who were born after 1992 were investigated, 33 cases of them were infected with HIV. The rate of vertical transmission was 38.4% (33/86). The HIV vertical transmission rate among mothers with AIDS (68.8%, 22/32) was significantly greater than that among mothers with asymptomatic HIV infection (20.4%, 11/54, P <0.05). The number of children infected with HIV through vertical transmission increased from 1993 to 2001. Among 37 children infected with HIV, 12 cases developed AIDS and 4 of them died, of whom 2 cases died from tuberculosis. The morbidity of AIDS was 27.3%(9/33). Ninety three point nine percent (31/33) of infected mothers didn′t know their HIV seropositive status before pregnancy and delivery. Of 8 pregnant women infected with HIV, one had aggravation of AIDS, 2 had miscarriege, 2 terminated their pregnancy and 3 continued their pregnancy. Conclusion Mother-to-child transmission of HIV was the major route of HIV/AIDS transmission to the children. The main reason leading to HIV infection in children was the lack of prenatal HIV counseling and testing for the high-risk women of childbearing age and

关 键 词：农村 儿童 人类免疫缺陷病毒感染 艾滋病 高发区 检测 

分 类 号：R725.1[医药卫生—儿科]