奈韦拉平与齐多夫定对人类免疫缺陷病毒暴露婴儿母婴阻断结局和肝功能以及血常规的影响

Effects of nevirapine and zidovudine on maternal-infant blocking outcome,liver function and blood routine in infants exposed to human immunodeficiency virus

目的探讨奈韦拉平与齐多夫定对人类免疫缺陷病毒(HIV)暴露婴儿母婴阻断结局、肝功能、血常规及生长发育的影响。方法选取2014年1月至2019年1月首都医科大学附属北京地坛医院收治的HIV感染患者分娩新生儿70例,最终纳入研究63例,根据出生后6 h内母婴阻断用药情况分为奈韦拉平组(37例)和齐多夫定组(26例)。比较2组婴儿性别、出生体质量和分娩方式等基本资料,HIV母婴阻断效果和HIV抗体转阴率,出生6周和出生3个月的生长发育情况、肝功能和血常规。结果2组新生儿性别、出生体质量、低出生体质量儿比例和分娩方式比较差异均无统计学意义(均P>0.05)。2组婴儿出生6周、3个月HIV-RNA均阴性,HIV母婴阻断效果均为100%,出生24个月2组婴儿HIV抗体均转阴,阻断成功率均为100%。出生6周,奈韦拉平组总蛋白水平低于齐多夫定组[(52.62±0.48)g/L比(55.01±0.57)g/L],白细胞计数高于齐多夫定组[(8.34±0.42)×10^(9)/L比(6.99±0.19)×10^(9)/L](均P<0.05),2组婴儿出生6周和出生3个月的体质量、头围、身长以及其他肝功能、血常规指标水平比较差异均无统计学意义(均P>0.05)。结论奈韦拉平与齐多夫定对HIV暴露婴儿母婴阻断结局和生长发育均无影响,奈韦拉平对肝功能中总蛋白生成有影响,齐多夫定对造血功能有一过性抑制作用,二者均能对HIV进行完全阻断。

Objective To investigate effects of nevirapine and zidovudine on maternal-infant blocking outcome,liver function and blood routine in infants exposed to human immunodeficiency virus(HIV).Methods From January 2014 to January 2019,70 cases of newborns with HIV infection in Beijing Ditan Hospital,Capital Medical University were selected,and 63 cases were finally included in the study.According to the use of blockade drug within 6 h after birth,they were divided into nevirapine group(37 cases)and zidovudine group(26 cases).The basic data such as gender,birth weight and mode of delivery,maternal-infant blocking effect of HIV,the negative conversion rate of HIV antibody,the growth and development situation,liver function and blood routine at 6 weeks and 3 months after birth were compared between the two groups.Results There were no significant differences in gender,birth weight,proportion of low birth weight and mode of delivery between the two groups(all P>0.05).HIV-RNA was negative in both groups at 6 weeks and 3 months after birth,and the HIV maternal-infant blocking effects were 100%.The HIV antibody of infants in the two groups turned negative at24 months of birth,and the success rates of blockade were 100%.At 6 weeks of birth,the total protein level of nevirapine group was lower than that of zidovudine group[(52.62±0.48)g/L vs(55.01±0.57)g/L],and WBC of nevirapine group was higher than that of zidovudine group[(8.34±0.42)×10^(9)/L vs(6.99±0.19)×10^(9)/L](both P<0.05).There were no significant differences in body weight,head circumference,body length,other liver function and blood routine indexes levels between the two groups at 6 weeks and 3 months of birth(all P>0.05).Conclusions Nevirapine and zidovudine have no effects on the outcome of maternal-infant blocking and growth and development of HIV exposed infants.Nevirapine has an effect on the production of total protein in liver function,and zidovudine has a transient inhibitory effect on hematopoietic function.The two drugs can blockade HIV completely.