中国2004—2010艾滋病母婴传播率及母婴阻断药物应用状况的系统评价

Mother-to-child transmission rate of HIV and use of drugs to prevent the transmission in China:a systematic review

目的了解我国2004—2010年艾滋病母婴传播及母婴阻断药物应用状况。方法全面检索中国生物医学文献数据库（CBM）和PubMed等中英文数据库中中国艾滋病母婴传播相关文献,检索时间均从建库到2013年5月。对纳入的文献采用参照AHRQ横断面研究评价标准和STROBE声明拟定的4条标准进行质量评价。将样本量、监测地点和监测年份作为主要异质性来源进行meta回归分析。采用Comprehensive Meta-Analysis V2.0software进行meta分析。结果共检索到2 356篇文献,最终纳入51篇进行分析。2004—2010年我国艾滋病母婴传播率依次分别为12.90%（95%CI：7.48%-21.36%）、16.35%（95%CI：10.41%-24.73%）、6.45%（95%CI：3.73%-10.93%）、6.25%（95%CI：2.39%-15.36%）、5.56%（95%CI：2.79%-10.76%）、3.10%（95%CI：1.59%-5.97%）、2.29%（95%CI：1.36%-3.83%）,孕产妇中阻断药物应用率依次分别为70.39%（95%CI：24.42%-94.59%）、71.99%（95%CI：61.49%-80.54%）、78.79%（95%CI：70.19%-85.43%）、86.84%（95%CI：79.24%-91.94%）、82.71%（95%CI：76.62%-87.48%）、81.85%（95%CI：75.55%-86.80%）、86.16%（95%CI：53.20%-97.15%）;2005—2010年婴儿阻断药物应用率依次分别为80.72%（95%CI：72.89%-86.70%）、81.84%（95%CI：71.55%-88.98%）、85.43%（95%CI：80.99%-88.97%）、89.75%（95%CI：81.82%-94.45%）、92.39%（95%CI：84.97%-96.31%）、90.34%（95%CI：85.50%-93.68%）。结论近年来我国艾滋病母婴传播率呈下降趋势,孕产妇及婴儿阻断药物应用率都有所升高。

Objective To understand the mother-to-child transmission rate of human immunodeficiency virus（HIV）and the use of drugs to prevent the transmission in China from 2004 to 2010.Methods English and Chinese databases including PubMed,Chinese Biomedical Literature database（CBM）,etc.were searched to retrieve the relevant references from the start to May 2013.Quality evaluation of the included studies was performed with four criteria which was compiled according to AHRQ cross-sectional study evaluation standards and the STROBE statement.The sample size,recruitment venue and studyyear were taken as the main source of heterogeneity in meta regression analysis.The data was analyzed by Comprehensive MetaAnalysis V2.0software.Results A total of 2 356 references were retrieved,and 51 of them were finally included in metaanalysis.In 2004-2010,the mother-to-child transmission rates of HIV were 12.90%（95% CI：7.48%-21.36%）,16.35%（95%CI：10.41%-24.73%）,6.45%（95% CI：3.73%-10.93%）,6.25%（95% CI：2.39%-15.36%）,5.56%（95% CI：2.79%-10.76%）,3.10%（95% CI：1.59%-5.97%）,and 2.29%（95% CI：1.36%-3.83%）,respectively.Meanwhile,From 2004to2010,the drug use rates for HIV antiretroviral prophylaxis among pregnant women were 70.39%（95% CI：24.42%-94.59%）,71.99%（95% CI：61.49%-80.54%）,78.79%（95% CI：70.19%-85.43%）,86.84%（95% CI：79.24%-91.94%）,82.71%（95% CI：76.62%-87.48%）,81.85%（95% CI：75.55%-86.80%）,and 86.16%（95% CI：53.20%-97.15%）,respectively.And in 2005-2010,the drug use rates for HIV antiretroviral prophylaxis among infants were 80.72%（95%CI：72.89%-86.70%）,81.84%（95% CI：71.55%-88.98%）,85.43%（95% CI：80.99%-88.97%）,89.75%（95% CI：81.82%-94.45%）,92.39%（95% CI：84.97%-96.31%）,and 90.34%（95% CI：85.50%-93.68%）,respectively.Conclusion The HIV mother-to-child transmission rate is decreasing in China in recent years,and the drug use rates of HIV antiretroviral prophylaxis are increasing among HIV-infected pregnant women and their infants.