不同高效抗逆转录病毒治疗方案对HIV感染孕妇母婴结局的影响分析

Analysis of the influence of different regimens of highly active antiretroviral therapy on maternal and infant outcomes in HIV-infected pregnant women

目的探讨不同高效抗逆转录病毒治疗方案(HAART)对人类免疫缺陷病毒(HIV)感染孕妇母婴结局的影响差异。方法将2015年5月至2018年6月期间,在广州市第八人民医院采用抗病毒治疗并分娩的人类免疫缺陷病毒感染孕妇,按不同用药方案分为两组,对两组孕妇孕期体重变化、CD4+T淋巴细胞数、白细胞、血红蛋白、血清白蛋白、新生儿体重及不良妊娠结局进行统计分析。结果(1)两组孕妇孕期体重变化、白细胞、血红蛋白和血清白蛋白比较,差异无统计学意义(P>0.05)。(2)两组孕妇治疗前后CD4+T淋巴细胞数变化,差异有统计学意义(P<0.05)。(3)两组孕妇出生新生儿体重、分娩孕周及Apgar评分比较,差异均无统计学意义(P>0.05)。(4)两组孕妇早产、胎膜早破、低出生体重儿、羊水过少、胎儿畸形及新生儿窒息发生率比较,差异均无统计学意义(P>0.05)。至2018年12月,两组婴儿HIV-RNA和HIV抗体检测暂无阳性报告。结论两种HAART方案对HIV感染孕妇营养状况、免疫状况及母婴结局影响无明显差异,均具有效性和可行性,可以阻断HIV母婴垂直传播。

Objective To compare the maternal and infant outcomes of pregnant women infected with human immunodeficiency virus(HIV)treated with different regimens of highly active antiretroviral therapy(HAART).Methods For pregnant women infected with the human immunodeficiency virus(HIV)who received antiviral therapy and delivered in the Eighth Peple’s Hospital of Guangzhu between May 2015 and June 2018,they will be grouped according to different treatment options. The pregnant women’s body weight,CD4+T lymphocytes,white blood cells,hemoglobin,serum albumin,neonatal body weight and adverse pregnancy outcomes were compared and analyzed.Results(1)There was no significantly statistical difference between the two groups of pregnant women in terms of body weight,white blood cells,hemoglobin or serum albumin(P>0.05).(2)The changes of CD4+T lymphocytes in the two groups of pregnant women before and after treatment were statistically different(P<0.05).(3)There was no significant difference in neonatal weight,gestational age or Apgar score between the two groups(P>0.05).(4)There was no significantly statistical difference in the incidence of premature birth,premature rupture of fetal membrane,low birth weight,low amniotic fluid,fetal malformation or neonatal asphyxia between the two groups(P>0.05).Until December 2018,there were no positive reports of HIVRNA and HIV antibody detection in two groups of infants.Conclusion The two HAART schemes have no significant difference in the influence on nutritional status,immune status or maternal and infant outcomes of HIV-infected pregnant women,and they are both effective and feasible,and vertical transmission of HIV from mother to child can be blocked.