河南省2002-2013年HIV母婴阻断效果分析

王奇; 孙定勇; 樊盼英; 马彦民; 马楠; 司珩; 李宁; 王哲

Abstract

王奇,孙定勇,樊盼英,马彦民,马楠,司珩,李宁,王哲.河南省2002-2013年HIV母婴阻断效果分析[J].Chinese journal of Epidemiology,2017,38(3):359-363

河南省2002-2013年HIV母婴阻断效果分析

Effectiveness of prevention of mother to child HIV transmission in Henan province, 2002-2013

Received:September 01, 2016

DOI：10.3760/cma.j.issn.0254-6450.2017.03.017

KeyWord: 艾滋病母婴传播婴儿影响因素

English Key Word: AIDS Mother to child transmission Infant Influencing factor

FundProject:河南省医学科技攻关计划项目（201403229）；国家科技重大专项（2012ZX10004905）

Author Name	Affiliation	E-mail
Wang Qi	Institute of STD/AIDS Control and Prevention, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China
Sun Dingyong	Institute of STD/AIDS Control and Prevention, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China
Fan Panying	Institute of STD/AIDS Control and Prevention, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China
Ma Yanmin	Institute of STD/AIDS Control and Prevention, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China
Ma Nan	Henan Provincial Academy of Medical Science, Zhengzhou 450016, China
Si Heng	Institute of STD/AIDS Control and Prevention, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China
Li Ning	Institute of STD/AIDS Control and Prevention, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China
Wang Zhe	Institute of STD/AIDS Control and Prevention, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China	wangzhe@hncdc.com.cn

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Abstract:

目的了解河南省2002-2013年感染HIV孕产妇分娩婴儿的母婴传播情况，分析其影响因素。方法采取随访研究的方法，分别在婴儿满1、3、6、9、12、18月龄时进行随访，收集2002-2013年度孕产妇检测及感染HIV孕产妇所分娩婴儿的有关干预信息，包括一般人口学特征、妊娠分娩、抗病毒药物应用、婴儿存活及18月龄HIV检测等情况，采用logistic回归对影响HIV母婴传播的有关因素进行分析。结果 2002年1月1日至2013年12月31日，共对8 621 554名孕产妇进行了HIV抗体检测，发现阳性孕产妇共2 264人，检测阳性率0.03%，孕产妇HIV检测阳性率呈现逐年递减趋势（χ²=4.871，P=0.027）。所分娩的1 530名婴儿中，有1 384人存活且满18月龄，已死亡婴儿92人，失访54人。已经检测的满18月龄的1 384名婴儿中阳性60人，阴性1 324人，存活婴儿累计母婴传播率4.34%，校正累计母婴传播率6.33%。产妇孕早期接受预防艾滋病母婴传播服务（OR=0.26，95% CI：0.09～0.77），产妇及婴儿进行抗病毒药物阻断（OR=0.42，95% CI：0.21～0.82），婴儿采取人工喂养（OR=0.06，95% CI：0.02～0.21）是预防艾滋病母婴传播的保护因素，产妇分娩过程采取侧切操作（OR=3.91，95% CI：1.74～8.80）是其危险因素。结论河南省孕产妇HIV检测阳性率保持在较低水平，并呈现逐年递减趋势，HIV的母婴传播率较高，应进一步加强并完善预防艾滋病母婴传播的综合干预措施。

English Abstract:

Objective To evaluate the effectiveness of the intervention on preventing mother to child transmission of HIV and identify the influencing factors. Methods The data regarding the pregnant women and their infants were collected, including demographic characteristics, pregnancy and delivery, access to antiviral therapy, HIV infection status at age 18 months and survival of infants between 2002 and 2013 through follow-up, Multivariate logistic regression model were used to identify the influencing factors. Results By the end of 2013, a total of 8 621 554 pregnant women received HIV test, among them 2 264 were infected with HIV. The positive rate of HIV is 0.03%. The HIV positive rate decreased year by year (χ²=4.871, P=0.027). A total of 1 530 infants were born from 2002 to 2013, among them 1 384 survived and 92 died at age of 18 months, and 54 were lost for follow up. Sixty infants were tested to be HIV-positive, 1 324 infants were tested to be HIV-negative. The mother to child transmission rate was 4.34%, the corrective mother to child transmission rate was 6.33%. Receiving HIV prevention service in early pregnancy (OR=0.26, 95%CI:0.09-0.77), standardized antiviral therapy (OR=0.42, 95%CI:0.21-0.82), artificial feeding (OR=0.06, 95%CI:0.02-0.21) might be the main protective factors, episiotomy on delivery (OR=3.91, 95%CI:1.74-8.80) might be the risk factors. Conclusion The HIV tested positive rate remained to be low and decreased year by year in pregnant women in Henan, but the mother to child HIV transmission rate was high. It is necessary to improve the prevention of mother to child HIV transmission.

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