感染HIV孕产妇及其所生婴幼儿应用抗反转录病毒药物的时间分布及变化趋势

Trends of applying antiretroviral drugs over time among HIV infected pregnant women and the infants

目的了解中国部分艾滋病高流行地区,感染艾滋病病毒(HIV)的孕产妇及其所生的0-18月龄婴幼儿应用抗反转录病毒(ARV)药物的时间分布及变化趋势。方法于2005年1月至2008年12月,对23个市/县/区的医疗保健机构发现的1 414名感染HIV的孕产妇及其所生婴幼儿,进行问卷调查及随访管理,收集他们所应用的ARV药物的方案、时间、持续时间、规范用药等信息。结果 2005-2008年,感染HIV的孕产妇,各年孕期用药的比例分别为10.27%、22.47%、40.85%和67.56%,差异有统计学意义(cmhχ2=232.06,P<0.000 1),用药比例上升幅度为57.29%;感染HIV孕产妇孕早、中、晚期用药比例从2005年的11.11%上升至2008年的25.00%,差异有统计学意义(cmhχ2=6.94,P=0.008 4)。2005-2008年,感染HIV孕产妇规范服用ARV药物的比例分别为95.82%(252/263)、92.70%(165/178)、85.62%(262/306)和73.19%(273/373),差异有统计学意义(cmhχ2=68.43,P<0.000 1)。结论尽管感染HIV的孕产妇孕期用药的比例有所上升,但其规范应用ARV药物的状况仍不理想。因此,应在保证早期用药的同时,加强感染HIV孕产妇长疗程用药的依从性和规范性。

Objective To describe the trends of applying antiretroviral（ARV） drugs over time among human immunodeficiency（HIV） infected pregnant women and the infants.Methods A face to face investigation via questionnaire was conducted among 1 414 HIV infected mother and their infants from 2005 to 2008 in 23 counties or districts with high HIV prevalence.The information of antiretroviral drug regimens,application time,duration of using ARV drugs,and other related information was collected.Results The proportion of HIV positive pregnant woman receiving ART in pregnancy in the respective years from 2005 to 2008 were 10.27%,22.47%,40.85% and 67.56%.The rate rose year by year（cmhχ2=232.06,P0.000 1）.Meanwhile,the proportion of ARV drug usage during the early and middle gestational periods rose from 11.11% in 2005 to 25.00% in 2008（cmh χ2=6.94,P=0.008 4）.In the years of 2005 and 2008,the proportions of standardized ARV drug application were 95.82%（252/263）,92.70%（165/178）,85.62%（262/306） and 73.19%（273/373）,respectively（cmhχ2= 68.43,P0.000 1）.Conclusion Although the proportion of ARV drug usage among HIV infected mothers during pregnancy increased,the standardized application of ARV drugs is still low.Therefore,ARV drugs should be applied as early as possible,and meanwhile compliance and standardization of ARV drug application among infected pregnant women during long term treatment should be strengthened.