艾滋病病毒在有偿献血员家庭子代传播的回顾性研究

Retrospective study on acquired immunodeficiency virus mother-to-child and father-to-child transmission among the families with HIV-infected former paid blood donors in China

【目的】 研究艾滋病病毒通过父亲或母亲传播给子代的发生率及其影响因素。 【方法】 通过对中国中部地区某行政村有偿献血员家庭进行HIV筛查和回顾性问卷调查 ,根据有偿献血员献血地点、时间和子女的出生时间确定研究对象。 【结果】 共有 3 2个家庭 46名儿童符合入选标准 ,其中父亲HIV阳性而母亲阴性家庭 17个 ,儿童 2 5名 ,子代HIV感染发生率为 0 ;父亲HIV阴性而母亲阳性家庭 7个 ,儿童 12名 ,子代HIV感染率为16.67%;父母亲均为HIV阳性的家庭 8个 ,儿童 9名 ,子代感染率为 44 .44 %;父亲HIV阴性而母亲阳性的家庭与父母均为HIV阳性家庭的子代感染率差异无显著性 ,合并后子代HIV感染为 2 8.5 7%;HIV阳性儿童母亲HIV感染至怀孕前的时间显著少于HIV阴性儿童的母亲 ;有 3名HIV阳性儿童的感染发生在母乳喂养期。 【结论】 未见到HIV“父婴传播”存在 ,“母婴传播”概率为 2 8.75 %。

To study both HIV mother to child and father to child transmission rates and related factors among the families with HIV infected former paid blood donors in the middle of China. All members of the families with former paid blood donors of one village in the middle of China were asked to participate in the HIV screening, and those at and over the age of 16 years filled in the corresponding questionnaire relating to demographic status, sexual behavior, drug use, and the history of paid blood donation including blood bank type, frequency and time. Women also answered the questions about the history of childbirth, type and interval of child feeding. The target families in the study must meet the following criteria: firstly at least one of parent was HIV positive or died from acquired immunodeficiency syndrome (AIDS), secondly the children were born after their parents’ HIV infection. There were totally 46 children from 32 families in the study. No HIV infected children were found among 25 children who came from 17 HIV discordant parents with only HIV infected fathers, 2 children got HIV infection among 12 children from 7 discordant parents with only HIV infected mothers, and 4 HIV infected children among 9 children from 8 accordant HIV positive parents. No significant difference was found between the children from only HIV infected mothers and from accordant HIV positive parents with respect to HIV vertical transmission rate (16.67% vs. 44.44%, P =0.33), total was 28.57%. The interval from HIV onset of mother to childbirth in HIV positive children was significantly less than that in HIV negative children, and 3 children got HIV infection because of breast feeding. [Conclusions] HIV paternal child transmission rate is very rare, and HIV maternal child transmission rate in China is similar with those in western countries. Breastfeeding is a very important pathway in HIV vertical transmission for Chinese children. Retrospective study with large samples is strongly recommended to get precise maternal child transmission rate in HIV epidemic region, which is 28.57%,especially the region having large number of former paid blood donors.