文章摘要
汤柳英,张畅斌,高爽,王智强,缪华章,夏建红.广东省2014-2017年HIV感染孕产妇及暴露婴儿流行病学特征分析[J].中华流行病学杂志,2019,40(11):1392-1397
广东省2014-2017年HIV感染孕产妇及暴露婴儿流行病学特征分析
Epidemiological characteristics of HIV infected pregnant women and exposed infants in Guangdong province, 2014-2017
收稿日期:2019-02-13  出版日期:2019-11-26
DOI:10.3760/cma.j.issn.0254-6450.2019.11.010
中文关键词: HIV  母婴传播  早期诊断  影响因素
英文关键词: HIV  Mother-to-child transmission  Early infant diagnosis  Influencing factors
基金项目:国家科技重大专项(2015ZX10001001)
作者单位E-mail
汤柳英 广东省妇幼保健院, 广州 511442  
张畅斌 广东省妇幼保健院, 广州 511442  
高爽 广东省妇幼保健院, 广州 511442  
王智强 广东省妇幼保健院, 广州 511442  
缪华章 广东省妇幼保健院, 广州 511442  
夏建红 广东省妇幼保健院, 广州 511442 xixixia58@126.com 
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中文摘要:
      目的 了解广东省HIV感染孕产妇及暴露婴儿流行病学特征,分析HIV母婴传播(MTCT)相关影响因素。方法 利用"全国预防HIV MTCT信息管理系统"和"广东省婴儿HIV感染早期诊断检测信息管理平台"监测数据,收集分娩时间为2014年1月1日至2017年12月31日的HIV感染孕产妇及暴露婴儿的个案信息,比较HIV暴露婴儿感染组和未感染组孕产妇的人口学特征、孕产史、接受预防MTCT服务及婴儿早期诊断检测等的差异性。采用logistic回归模型分析HIV感染孕产妇和暴露婴儿MTCT的相关影响因素。结果 349例HIV感染孕产妇中,分别在孕前、孕期、产时/产后获知感染状态的占30.4%(106/349)、49.6%(173/349)和20.0%(70/349),性伴感染状态不明确的占39.5%(138/349),未治疗的占13.2%(46/349);暴露婴儿中,MTCT率为4.2%(15/353),第1、第2次早诊断检测的年龄分别为44(P25~P75:42~50)、96(P25~P75:92~106)d。单因素logistic回归分析结果显示,产时/产后明确感染状态(与孕前确认感染状态相比,OR=5.72,95%CI:1.52~21.61)、孕产妇和暴露婴儿的一方或双方未抗病毒治疗(与孕产妇和暴露婴儿均抗病毒治疗相比,OR=33.56,95%CI:9.04~124.55)增加MTCT风险;人工喂养(与母乳喂养相比,OR=0.07,95%CI:0.01~0.76)可降低MTCT风险。结论 广东省孕产妇的早检测早诊断、抗病毒治疗、人工喂养的多措并举,提高预防MTCT服务能力,有效降低MTCT风险。
英文摘要:
      Objective To analyze the epidemiological characteristics of HIV-infected pregnant women and exposed infant in Guangdong province and identify the factors associated with infant HIV infection through mother-to-child transmission. Methods National Information System for Prevention of mother-to-child HIV Transmission and Early Infant Diagnosis Information Management Platform were used to collect the individual information about HIV-infected pregnant women and exposed infants who were delivered in Guangdong from January 1, 2014 to December 31 in 2017. The differences in pregnant women's demographic data, history of pregnancy and childbirth, the utilization of mother-to-child transmission prevention services and early infant diagnosis between the infected HIV exposed infants and uninfected HIV exposed infants were compared, and univariate and multivariate logistic regression analyses were conducted to identify the factors associated with mother-to-child HIV transmission. Results Among 349 HIV infected pregnant women, the proportions of the pregnant women whose HIV infection status were confirmed before pregnancy, during pregnancy and at or after childbirth were 30.4% (106/349), 49.6% (173/349) and 20.0% (70/349) respectively. The proportions of those with sexual partners whose HIV infection status were unknown and those receiving no antiviral treatment were 39.5% (138/349) and 13.2% (46/349) respectively. Among the HIV exposed infants, the mother-to-child transmission rate was 4.2%(15/353), the HIV exposed infants had the first or second early diagnosis tests within 44 (P25-P75:42-50) days and 96 (P25-P75:92-106) days after birth, respectively. Univariate logistic regression analysis indicated that the risk for mother-to-child HIV transmission increased in those whose HIV infection status were confirmed at or after childbirth compared with before pregnancy (OR=5.72, 95%CI:1.52-21.61) and in the group that antiviral treatment was given to either mothers or infants compared with the group that antiviral treatment was given to both mothers and infants (OR=33.56, 95%CI:9.04-124.55), while there was lower mother-to-child HIV transmission risk in artificial feeding group compared with breast feeding group (OR=0.07, 95%CI:0.01-0.76). Conclusion The risk of mother-to-child HIV transmission in Guangdong can be effectively reduced by the measures of early diagnosis, antiviral treatment and artificial feeding as well as the improvement of mother-to-child transmission prevention service.
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