HAART预防艾滋病母婴传播的可行性和有效性

The feasibility and effectiveness of highly active antiretroviral therapy in preventing mother-to-child transmission of HIV

目的总结和分析在云南省边远的农村地区,对孕妇实施高效反转录病毒治疗(HAART)以预防艾滋病病毒(HIV)母婴传播(PMTCT)的有效性和可行性。方法梳理和定量分析2005-2012年,云南省与美国艾伦戴蒙德艾滋病研究中心开展的预防艾滋病母婴传播项目的效果。结果在1 861名HIV阳性孕妇中,1 353名孕妇(72.7%)采用了HAART阻断方案。在1 584名有HIV检测结果的婴儿中,阳性25人,阳性率为1.58%;其中1 168名采用HAART妇女所生的婴儿中,仅有9人阳性,阳性率为0.8%;在孕28周前开始HAART的妇女所生婴儿中,HIV阳性率为0.2%(2/899)。结论 HAART对于阻断HIV母婴传播效果非常显著,如果在孕28周前开始HAART,婴儿HIV感染率已经非常接近"零感染"的目标,可以推广和实施。

Objective To summarize the effectiveness and feasibility of highly active antiretroviral therapy （HAART） in preventing mother-to-child transmission of HIV （PMTCT） in rural, resource limited regions of Yun- nan Province. Method The effect of PMTCT program conducted by Yunnan Province and Aaron Diamond AIDS Research Center from 2005 to 2012 was quantitatively analyzed. Results Of a total of 1861 HIV positive women received PMTCT at the program sites, 72.7% （1353/1861） initiated HAART during pregnancy. Of the 1584 chil- dren who had HIV testing results, 25 （1.58%） were HIV positive. Of the 1168 children whose mothers initiated HAART prophylaxis in pregnancy, 9 （0.77 %） were infected. For children whose mothers initiated HAART before 28 weeks of pregnancy, only 2 （0.22%） were HIV positive. Conclusion HAART prophylaxis is highly effective in preventing mother to child transmission of HIV. Our program results suggest that if HAART prophylaxis is initi- ated before 28 weeks of pregnancy, mother to child transmission of HIV can be virtually eliminated. HAART prophylaxis should be implemented and scaled up.