中国中部地区HIV母婴传播状况调查及其相关因素分析

Investigation of the Prevalence of HIV and Analysis of the Risk Factors in Central China

目的:了解人类免疫缺陷病毒(HIV)在我国以血液传播为主的中部地区母婴传播率及影响母婴传播的相关因素,为开展预防阻断工作提供根据。方法:以当地因有偿供血或受血感染HIV后有生育史的妇女为调查对象,现场询问调查和检测,并对其子女配对的资料进行整理,回顾性分析HIV的母婴传播状况。结果:159例HIV阳性母亲生育的204名子女中,78例HIV阳性,母婴传播率为38.2%(78/204)。在159例HIV阳性母亲中,有39例为产后输血感染,所生的40名子女均母乳喂养,其中13例感染HIV,母乳传播率为32.5%(13/40)。对母婴传播的影响因素进行分析发现,母亲年龄、生产胎次对母婴传播率有一定影响,母亲年龄>30岁、多产的母婴传播率分别为48.5%、47.9%,高于母亲年龄<30岁、初产的36.2%、35.3%,但差异无统计学意义。胎儿性别也不影响母婴传播率。结论:在我国以有偿供血和受血为主要传播途径的中部地区,母婴传播率达38.2%,高于性传播和静脉吸毒的母婴传播率;影响母婴传播的因素是多方面的,其中HIV亚型作用不能排除。

Objective： To understand the scenario on how HIV is prevailing among the central part of china through mother-to-child transmission and by breast-feeding, and to provide proper intervention approaches. Methods： The investigation was focused on HIV-positive women post delivery and their progenies living in central China during Jan, 2001 to Feb, 2006. After consultation, the venous blood samples were taken and the plasma was isolated and stored at -20 ℃ for following detection. If the detection was positive, the data were analyzed to try to reason the route of transmission and infection. Results： While 159 HIV positive mothers delivered 204 children, 78 of them came out to be positive, rate of transmition from mother to child being 38. 2%. Among them, 39 patients were infected through blood transfusion. Of the 40 breast-feeding infants, 13 got HIV-positive and the transmission rate was as high as 32.5%. After statistic analysis, it was revealed that the transmission rate correlated with mother＇s age and birth times. The HIV transmission rate of mothers older than 30 years and of multiparous mothers was 48.5 % and 47.9%, respectfully, which was respectively much higher than that of younger than 30 years and primiparous mothers. Conclusion. Among the areas prevailing in blood selling, the HIV-positive rate of mother to child transmission was 38.2%, much higher than that of sex transmission and intravenous drug injection. There were many factors affecting the rate of mother to child transmission, and among them the HIV sub-type factor has to be considered.