文章摘要
胡芳,卢建军,梁晶晶,朱穗,于佳,邹兴文,胡艳,林穗方.HIV暴露未感染儿童预防性用药对其体格生长发育的影响[J].中华流行病学杂志,2019,40(7):770-774
HIV暴露未感染儿童预防性用药对其体格生长发育的影响
Influence of antiretroviral prophylaxis on growth of HIV-exposed uninfected infants
收稿日期:2019-01-16  出版日期:2019-07-17
DOI:10.3760/cma.j.issn.0254-6450.2019.07.007
中文关键词: HIV暴露未感染  儿童  生长  预防性用药
英文关键词: HIV-exposed uninfected  Child  Growth  Antiretroviral prophylaxis
基金项目:中国性病艾滋病防治协会·艾伯维妇幼关爱及预防母婴传播基金(PMTCT2018-001);中国疾病预防控制中心妇幼中心合生元母婴营养与健康研究基金(2018FYH008)
作者单位E-mail
胡芳 广州医科大学附属广州市妇女儿童医疗中心儿童保健部 510623  
卢建军 中山大学附属第一医院医务处, 广州 510080  
梁晶晶 广州医科大学附属广州市妇女儿童医疗中心儿童保健部 510623  
朱穗 暨南大学基础医学院预防医学系卫生统计教研室, 广州 510632  
于佳 广州医科大学附属广州市妇女儿童医疗中心妇女保健部 510623  
邹兴文 广州医科大学附属广州市妇女儿童医疗中心妇女保健部 510623  
胡艳 广州医科大学附属广州市妇女儿童医疗中心儿童保健部 510623  
林穗方 广州医科大学附属广州市妇女儿童医疗中心儿童保健部 510623 739834696@qq.com 
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中文摘要:
      目的 了解广州市HIV暴露未感染(HEU)儿童预防性用药对其体格生长发育的影响。方法 数据来自国家“预防艾滋病、梅毒和乙肝母婴传播管理信息系统”实时监测收集的广州市HIV感染孕产妇及其所生儿童检测治疗与随访等信息,剔除婴儿死亡及感染HIV个案,共纳入564例HEU儿童。HEU儿童预防性用药方案分为3种情况:奈韦拉平(NVP)、齐多夫定(AZT)和未用药,采用广义估计方程等方法分析HEU儿童预防性用药对其体重、身长等的影响。结果 HEU儿童1月龄时,年龄别体重Z分、年龄别身长Z分略低于WHO的参考标准,服用AZT组消瘦发生率(17.5%)高于服用NVP组(6.2%)。儿童预防性服用NVP或AZT是HEU儿童年龄别身长Z分的保护因素,宫内暴露三联抗病毒药物是HEU儿童年龄别体重Z分、年龄别身长Z分的危险因素(P<0.05)。结论 1月龄HEU儿童体格生长发育状况欠佳,服用AZT的HEU儿童满月时消瘦发生率更高,应重点关注。
英文摘要:
      Objective To evaluate the influence of antiretroviral prophylaxis on the growth and development of HIV-exposed uninfected infants in Guangzhou. Methods Data were from the national information system for prevention of mother-to-child transmission of HIV infection, syphilis and hepatitis B. After excluding death and perinatal HIV infection cases, 564 HIV-exposed uninfected infants were included. The infants were divided into three groups, nevirapine (NVP) group, zidovudine (AZT) group and untreated group. The influences of antiretroviral prophylaxis on the body weight and height of the HIV-exposed uninfected infants were analyzed by using generalized estimating equations. Results The HIV-exposed uninfected infants at 1-month old had lower Z scores of body weight-for- age and body height-for-age than the World Health Organization's reference standard. The prevalence of wasting in AZT group (17.5%) was higher than that in NVP group (6.2%) for 1-month old infants. Taking NVP or AZT was a protective factor for Z score of body length-for-age (P<0.05). Intrauterine exposure to triple antiviral drugs was a risk factor for the Z scores of body weight-for-age and body length-for-age (P<0.05). Conclusion The physical growth and development of HIV-exposed uninfected infants at 1-month old was not well, and HIV-exposed uninfected infants who taking AZT had a higher incidence of wasting. Attention should be paid to these infants.
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