HIV-Ⅰ宫内传播危险因素的系统评价

System Evaluation of Risk Factor on HIV-Ⅰ Intrauterine Transmission

目的综合评价HIV-Ⅰ宫内传播发生的危险因素。方法计算机检索MIDLINE及中国生物医学文献数据库,手工检索和引文检索作为补充。对纳入的文献进行质量评价后提取数据信息。采用专用软件Rev Man 4.2.2完成系统评价过程。结果本次研究纳入文献8篇,HIV-Ⅰ宫内传播组CD4+细胞计数低于未传播组,WMD=-164.58 95%CI为(-203.64,-125.51);宫内传播组的CD4+/CD8比率低于未传播组,WMD=-0.17,95%的可信区间(-0.22,-0.13);HIV-Ⅰ宫内传播组血清病毒载量高于未传播组,WMD=1.08 95%的置信区间为(0.36,1.81);宫内传播组的低体重婴儿的发生率高于未传播组。宫内传播组的出生体重低于未传播组的出生体重。宫内传播组的胎盘感染及相关疾病高于未传播组。结论母体的免疫状况、病毒水平、胎盘炎症及其他疾病的发生、及胎儿因素等都与宫内感染有关,其中母体免疫状况、病毒水平是HIV-Ⅰ宫内感染的发生的高危因素。另外母体胎盘炎性疾病、其他疾病、早产、低出生体重与HIV-Ⅰ宫内感染的发生也有关系。

Objective To evaluate the risk factors of HIV - Ⅰ intrauterine transmission. Methods We searched MEDLIBE and CBM disc. Eight journals and the references of eligible studies were searched to extract the data messages after evaluated the quality of internalized studies. Rev Man 4.2.2 software was used for meta - analysis. Results CD4 ^＋ T - lymphocyte counts were low in intrauterine transmitting mothers, with WMD = -164.58 95% CI（ -203.64, - 125.51 }. Maternal HIV - Ⅰ viral load was high in intrauterine transmitting mothers, with WMD = 1.08 and 95 % CI （ 0.36,1.81 ）. The number of low birth - weight [ RR = 2.26, 95% CI（ 1.4, 3.65 ） ] and premature labor[ WMD = - 136.36, 95% CI （ - 234.18, - 38.54 ） ] in intrauterine transmitting mothers were more than that in non - transmitting mothers. Conclusions High ma- ternal viral load and low CD4^＋ T- lymphocyte are strong associated with intrauterine transmission. Low birth - weight and premature labor are associated with in utero - transmission.