中国2011-2014年艾滋病母婴阻断效果的Meta分析

Meta-analysis of effect of prevention of mother to child transmission of HIV during 2011-2014 in China

目的采用Meta分析方法，计算2011年1月至2014年4月中国公开发表文献的艾滋病母婴传播率，评价母婴阻断效果。方法检索万方数据资源系统、中国医院知识库和Pubmed数据库，收集关于艾滋病母婴阻断效果的文献，参照疾病患病率或发病率研究质量评价准则，评价文献的质量，对纳入的文献进行异质性检验，采用随机效应或固定效应模型合并效应量，评价发表偏倚，运用敏感度分析评价文献质量和文献样本量对研究结果的影响。结果共纳入19篇文献，总样本量4787人，总阳性数113人，合并结果后母婴传播发生率为2．27％E95％可信区间（CJ）：1．43％～3．59％]。亚组分析结果表明，不同经济发展水平、不同疫情程度地区间艾滋病母婴传播率差异无统计学意义。通过敏感度分析删除1篇多地研究后，Meta分析结果略有降低。结论通过实施规范性母婴阻断措施后，中国艾滋病母婴阻断效果与发达国家类似，但母婴阻断工作仍存在问题，亟须加强。

Objective To calculate mother to child transmission（MTCT） rate of HIV of published articles from January 2011 to April 2014 in China through meta-analysis method and to estimate the effect of prevention of mother to child transmission of HIV. Methods Publications with respect to effect of AIDS block between mother and in- fants were collected from Wanfang data, China Hospital knowledge database and Pubmed databases. Each incorpo- rated article was given a score to represent its quality by reference to criteria for prevalence or incidence research quality. Fixed effects model or random effects model was performed according to Heterogeneity test results. We evaluated publication bias and employed sensitivity analysis to determine the impact of research quality and sample size. Results A total of 19 documents were extracted, with a sample size of 4787 and positive number of 113. MTCT rate of HIV was 2.27% （95CI：1.43-3.59） after combination. Subgroup analysis indicated that MTCT rate in different regions showed no significant difference. Combined MTCT rate turned to be 4.32 % （95CI： 3.51-5.31） after low scored papers being removed. Conclusion MTCT rate of our country is as low as developed countries, but there remains some problems in prevention of mother to child transmission that should be strengthened continu- ously.