艾滋病高度流行地区婴儿HIV暴露对免疫规划接种的影响

Effect of infantile HIV exposure on program immunization in high HIV prevalence areas

目的探讨艾滋病高度流行地区婴儿HIV暴露对其免疫规划疫苗接种的影响。方法抽取2013年6-11月云南省艾滋病高度流行地区HIV感染母亲所生0~35月龄婴幼儿300例为HIV暴露组,在同一地区配对选取HIV非感染母亲所生同月龄婴幼儿300例作为对照组,问卷调查婴幼儿主要照顾者,并对婴幼儿免疫接种情况进行记录。结果婴幼儿免疫规划各疫苗针次接种率暴露组最高为69.5%,最低为43.0%;对照组最高为79.5%,最低为43.5%。疫苗接种延迟时间乙肝首针、乙肝第2针、麻风疫苗暴露组短于对照组,其余疫苗暴露组延迟时间均高于对照组,流脑疫苗接种延迟时间最长。暴露组疫苗及时接种率低于对照组,差异有统计学意义(P<0.05)。除乙肝首针(RR=1.292)、百白破首针(RR=1.395)外,HIV暴露显著影响了大多数疫苗接种和疫苗接种的及时性。结论艾滋病高度流行地区婴幼儿HIV暴露对其免疫接种和接种及时性均有影响,该地区婴幼儿无论有无HIV暴露,其免疫规划疫苗接种水平均有待提高。

Objective To explore the effect of infantile HIV exposure on program immunization in high HIV prevalence areas. Methods A total of 300 infants under 35 months born by HIV-infected mothers in high HIV prevalence areas of Yunnan province from June to November in 2013 were selected as HIV exposure group; 300 infants under 35 months born by mothers without HIV infection in high HIV prevalence areas of Yunnan province were selected as control group. A questionnaire survey was conducted among the main caregivers, and the immunization records of infants were recorded. Results The coverage rate of each vaccine in HIV exposure group ranged from 43.0% to 69.5% ; and the coverage rate of each vaccine in control group ranged from 43.5% to 79.5%. The delay time of the first HBV injection vaccine, the second HBV injection vaccine, and leprosy vaccine in HIV exposure group was shorter than that in control group, the delay time of other vaccines in HIV exposure group was longer than that in control group, the delay time of epidemic encephalitis vaccine was the longest. The prompt vaccination coverage rate in HIV exposure group was statistically significantly lower than that in control group （P〈0. 05） . Except for the first dose of HBV （ RR = 1. 292） and DVF （ RR = 1. 395 ） , HIV exposure significantly affected the coverage rate of vaccine and prompt vaccination. Conclusion In high HIV prevalence areas, infantile HIV exposure may affect the coverage rate and prompt vaccination. Program immunization needs to be improved both in HIV exposed infants and non-HIV exposed infants.