输血感染艾滋病病毒1型母婴传播概率回顾性定群研究

Retrospective cohort study on the rate of mother-to-child transmission among mothers infected with human immunodeficiency virus type 1 through blood transfusion

目的研究HIV-1型母婴传播率。方法对某市8个乡全部居民普查出的63例一次性输血感染HIV的母亲及其子女进行研究，调查母亲的受血时间、子女的出生时间、出生方式、母乳喂养等情况。母亲输血感染HIV的84名子女作为母婴传播的观察对象，采集的血清标本用ELISA法进行HⅣ抗体初筛，用Western-blot法进行确证。结果存在母婴传播危险因素的子女母婴感染率为32．1％（27／84）。存在宫内、分娩、母乳3个因素和存在分娩、母乳2个因素的感染率分别为36．8％（7／19）和35．7％（5／14），存在宫内、分娩2个因素的感染率为14．3％（2／14）；单纯母乳喂养感染率为37．9％（11／29）。经合并分析，存在母乳喂养凶素的母婴传播组HIV-1感染率（36．9％，24／65）显著高于人工喂养的母婴传播组（11．8％，2／17）。结论一次性输血感染HIV的母亲，母婴感染率因传播危险因素不同而有所不同，母乳喂养在母婴传播HIV中具有重要作用。

Objective To study the rate of mother-to-child transmission （MTCT） on HIV-1. Methods All local residents from 8 townships in a region were screened for mothers who had a history of only one blood transfusion and 63 were found HIV-1 positive. A further study on these HIV-1 positive mothers and their children was conducted with the emphasis on the date of receiving blood transfusion, date and type of nationality, history regarding breastfeeding and so on. Sera specimens from 84 children born from 63 HIV-1 positive mothers were screened, using ELISA for HIV-1 antibody, and positive specimens were confirmed by Western-blot. Results The rate of MTCT was 32.1%（27/84） for children with all risk factors related to MTCT. Another 36.8% （7/19） were related to factors on intrauterine, intrapartum and breastfeeding, 35.7% （5/14） to intrapartum and breastfeeding factors, 14.3% （2/14） to intrauterine and intrapartum factors, 37.9% （11/29） to breastfeeding factor alone. By group combination analysis, the MTCT rate was 36.9% （24/65） with breastfeeding, 11.8% （2/17） with artificial feeding, and the former was significantly higher than the latter. Conclusion HIV-1 MTCT rate among mothers caused by a single blood transfusion varied with different risk factors. Breastfeeding played an important role in MTCT, appeared in our study.