周口市278例艾滋病母婴传播病例分析

Analysis on 278 cases of mother to child transmission of HIV in Zhoukou,Henan province

目的了解周口市艾滋病母婴传播病例的情况,评估预防艾滋病母婴传播工作的效果。方法分析全市艾滋病母婴传播病例报告情况,对2005年全面开展预防艾滋病母婴传播工作后出生的病例进行回顾性调查,分析感染原因。结果截至2013年底,周口市共报告母婴传播病例278例。2005年后,报告的母婴传播病例占当年出生儿童总数的比例呈显著下降趋势(χ2=94.3,P<0.01);2005年后出生的病例22例,其中1例(4.6%)为母亲孕期艾滋病病毒(HIV)检测阳性,采取规范的预防艾滋病母婴传播措施而阻断失败的病例。19例(86.4%)为母亲孕期未检测HIV或检测时间过晚,以致未采取或未能规范采取预防艾滋病母婴传播措施而造成的感染;2例(9.1%)母亲孕产期HIV检测"阴性",从而未采取预防艾滋病母婴传播措施。结论采取综合措施,加强孕期检测,提高孕期检测率是预防艾滋病母婴传播工作的关键;加强HIV检测管理和检测技术人员培训,是预防艾滋病母婴传播的一个重要环节。

Objective To explore status of cases of mother-to-child transmission（MTCT）of HIV in Zhoukou city and assess the effect of measures for prevention of mother-to-child transmission（PMTCT）of HIV.MethodsAnalyzed HIV case reports of MTCT and carried out a retrospective investigation for HIV cases of MTCT who were born after the comprehensive PMTCT work launched in 2005,to explore the causesof their infection with HIV.Results A total of 278 cases of MTCT of HIV were reported by the end of 2013.The proportion of reported cases accounted for total number of children born in that year were significantly decreased after 2005（χ^2=94.3,P ﹤0.01）;22HIV cases of MTCT were born since 2005.Among them,1（4.6%）case was infected with HIV,whose mother was confirmed HIV-positive during pregnancy and took the standard PMTCT measures including the application of antiviral drugs,artificial feeding,standardized follow-up for mothers and infants but prevention failure;19（86.4%）cases were infected with HIV because their mothers had not tested HIV antibody or tested too late during pregnancy,which resulted in not taking or failing to take regulated PMTCT measures;2（9.1%）cases were infected with HIV,because of HIV false negative detection during mother pregnancy resulted in not taking the PMTCT measures.Conclusion PMTCT work in Zhoukou had achieved good effectand MTCT of HIV had been effectively controlled.Comprehensive preventive measures and HIV testing during pregnancy were important for HIV PMTCT work.Management of HIV testing and training of HIV testing technicians were also key point of HIV PMTCT work.