194名HIV阳性孕妇临床特征分析

Analysis of clinical characteristics of 194 HIV positive pregnant women

目的 对广西4个市、县在产前门诊发现的194例艾滋病病毒（HIV）阳性孕产妇的人口学、流行病学临床及实验室特征进行描述性分析,了解HIV对孕产妇的影响.方法 针对在2006年10月到2009年2月广西省4个市、县发现的194例HIV阳性孕产妇人口学、流行病学、临床和实验室特征进行分析.结果 194名HIV阳性的孕妇的平均年龄（26±4.4）岁,大部分经性感染,其中孕早期和孕晚期发现的比例分别为14.4%和45.9%;孕产妇发现时的中位CD4和病毒载量分别为317个/mL和23 600拷贝/mL,CD4＜350和病毒载量≥100 000的病人所占比例超过54%和19%;61.9%和16.0%的孕妇发现时有贫血和机会性感染症状,机会性感染主要表现为反复发热、皮肤损害、呼吸道感染、结核和慢性腹泻;4.61%和67.01%的阳性孕产妇分别在怀孕前和怀孕期间接受高效抗逆转录病毒治疗,9.28%接受复方新诺明预防相关机会性感染.结论 尽早发现HIV阳性孕产妇,了解阳性孕产妇的流行病、人口学、临床及实验室特征是开展HIV阳性孕产妇干预和关怀的前提.

Objectives To analyze the demographic, epidemiological, clinical and laboratory characteristics of 194 HIV positive pregnant women visiting prenatal clinics in Guangxi and to explore the impact of HIV on pregnant women. Methods The data of demographic, epidemiology, clinical and laboratory characteristics of 194 HIV positive pregnant women diagnosed in four cities and counties of Guangxi from October 2008 to February 2009 were analyzed. Results The average age of 194 HIV pregnant women was 26 ＋4, 4 years. A majority of them were infected through sexual behavior. 14.4% and 45.9% of them were found at first and third trimester, respectively. Median CIM count was 317/mL and HIV viral load was 23 600eopies/mL when enrolled. There were 54% patients whose CD4 was lower than 350/mL and 19% whose viral load over 100 000 copies/mL. Anemia was common in 61.9% pregnant women, and opportunity infection （OI） was found in 16% pregnant women, the main manifestations of which included recurrent fever, skin lesion, respiratory infection, tuberculosis and chronic diarrhea. There were 4.61% and 67.01% HIV positive pregnant women receiving HAART before pregnancy and during pregnancy, and 9.28% of them received eotrimoxazole prophylaxis for OI prevention. Conclusion Early detecting of HIV positive pregnant women and understanding the epidemiologieal, demographic, clinical and laboratory characteristics of them are the priority strategies of implementing intervention and care for HIV positive pregnant women.