不同孕周高效抗反转录病毒治疗对HIV母婴阻断效果的比较

The effect of highly active antiretroviral therapy in women with different weeks of pregnancy( HAART) on preventing of HIV

目的探讨不同孕周抗反转录病毒治疗对HIV母婴阻断的效果。方法选择2012-01—2014-01就诊HIV感染孕妇，以AZT＋3TC＋LPV／r方案进行HIV母婴阻断，孕14周组30例，孕28周组30例。检测孕妇治疗前及预产期前一个月的CD4＋T淋巴细胞及病毒载量变化，观察婴儿出生情况及是否感染HIV（出生后18月龄进行HIV抗体检测）。结果孕14周组孕妇治疗前及预产期前一个月CD4＋T淋巴细胞高于孕28周组，病毒载量低于孕28周组（P〈0．05）。两组婴儿18月龄时HIV抗体阳性率差异均无统计学意义（P〉0．05）。结论采用相同高效抗反转录病毒治疗方案对孕14周、孕28周的HIV孕妇进行母婴阻断，婴儿结局相似，但孕14周组应用高效抗反转录病毒治疗比孕28周组在抑制病毒复制，减少病毒负荷量，降低病毒传播性的效果更为显著。

Objective To explore the effect of highly active antiretroviral therapy on blocking mother-to-in- fant transmission of HIV in women with different weeks of pregnancy （HAART）. Methods Sixty pregnant women in- fected with HIV were divided into the 14-week-pregnant group （n = 30） and the 28-week-pregnant group （n = 30 ）. Both of the two groups received AZT ＋ 3TC ＋ LPV/r from January 2012 to January 2014 to block mother-to-infant transmission of HIV. The changes of CD4＋ T lymphocytes and virus load were tested before the treatment and one month before due dates. The growth and development of the babies at birth were observed, and their HIV antibodies were detected when they were 18 months old. Results The CD4 ＋ T lymphocytes were significantly higher and the vi- res load was lower in the 14-week-pregnant women than those in the 28-week-pregnant women before the treatment and one month before their due dates （P 〈 0. 05）. There were no significant differences between the two groups in the conditions of the babies at birth including premature delivery, low birth weight, suffocating, and the positive rate of HIV antibody（P 〉 0.05）. Conclusion A similar outcome is showed in the babies of 14-week-pregnant women and 28-week-pregnant women, however less replication of virus and lower virus load are present in the babies of 14-week- pregnant women.