凉山彝族自治州773例HIV感染孕产妇ART效果及影响因素

Effect and influencing factors of antiretroviral treatment among 773 HIV-positive pregnant women in Liangshan prefecture,Sichuan

目的分析凉山彝族自治州HIV感染孕产妇ART效果及影响因素。方法利用全国预防艾滋病母婴传播管理信息系统数据,回顾性分析凉山彝族自治州2017-2019年773例接受VL检测的HIV感染孕产妇ART效果及其影响因素,采用χ2检验及Logistic回归模型分析ART效果的影响因素。结果773例HIV感染孕产妇中703例在孕早期接受产检,孕晚期VL检测比例为57.70%(446例);Logistic分析显示,孕早期接受ART者,孕晚期VL<50 copies/mm3的可能性是孕晚期接受ART的3.843倍(OR=3.843,95%CI:1.242~11.890,P=0.020),孕早中期首次VL<50 copies/mm3的感染孕产妇孕晚期VL仍维持<50copies/mm3的可能性是孕早中期未做病载检测的7.423倍(OR=7.423,95%CI:1.580~34.873,P=0.011)。结论尽早开始ART且孕早中期VL<50 copies/mm3能提高HIV感染孕产妇ART效果。

Objective To understand the effectiveness and influencing factors of antiretroviral therapy(ART)among HIV-positive pregnant women in Liangshan prefecture,Sichuan province,China.Methods We retrospectively analyze the data from the Management Information System of China’s Prevention of Mother-to-Child Transmission of HIV program from 2017 to 2019 in Liangshan prefecture,Sichuan province.Chi-square test and logistic regression model were used to explore influencing factors associated with antiviral treatment effect.Results Among 773 HIV-infected pregnant women receiving ART,768 received prenatal tests in the first trimester.The rate of viral load testing during the third trimester was 57.70%(446).Logistic analysis showed that those who received ART in the first trimester were 3.843 times more likely to have a viral load of<50 copies/mm3 in the third trimester than those who received ART in the third trimester(OR=3.843,95%CI:1.242~11.890,P=0.020).The probability of maintaining the viral load<50 copies/mm3 in the third trimester among those who had a first viral load test in the first and second trimester was 7.423 times higher than those who didn’t receive viral load testing in the first and second trimester of pregnancy(OR=7.423,95%CI:1.580-34.873,P=0.011).Conclusion Early initiation of antiviral therapy and viral load<50 copies/mm3 in early-to mid-gestation can improve the efficacy of antiviral therapy in HIV-infected pregnant women.