2015—2019年广西壮族自治区预防艾滋病母婴传播效果及影响因素分析

Effects and its risk factors of prevention of mother-to-child transmission of AIDS in Guangxi Zhuang Autonomous Region from 2015 to 2019

目的 了解广西壮族自治区预防艾滋病母婴传播效果及影响因素,为广西母婴传播工作提供科学依据。方法 对2015—2019年广西上报的HIV感染产妇及所生儿童个案卡资料进行回顾性分析,采用χ~2检验比较不同特征孕产妇所生儿童HIV抗体阳性率,采用Logistic回归模型分析其相关影响因素。结果 2015—2019年广西艾滋病感染产妇2759例,活产2778例。孕产妇抗病毒用药率、孕期用药率及所生儿童预防性治疗率呈上升趋势,2019年分别为97.29%、92.60%、99.28%。艾滋病母婴传播率在1.51%~3.08%之间波动,2019年为2.08%。多因素分析结果显示,与初检孕周在孕早期的HIV感染孕产妇相比,初检孕周在孕中期的孕产妇艾滋病母婴传播的风险更高(OR=2.115,95%CI:1.151~3.886);与孕早期抗病毒治疗的孕产妇相比,孕晚期治疗和未在孕期治疗的孕产妇所生儿童艾滋病感染的可能性更高(OR=4.321,95%CI:1.655~11.281;OR=15.235,95%CI:6.526~35.569);早产及未预防性治疗的HIV暴露儿童艾滋病感染的风险高于非早产、已预防性治疗的儿童(OR=4.398,95%CI:2.601~7.437;OR=4.708,95%CI:1.780~12.453)。结论 广西预防艾滋病母婴传播效果持续趋好;孕产妇进行保健孕周及抗病毒治疗时间晚、儿童早产及未预防性治疗是导致母婴传播的危险因素;应加强宣教,严格落实预防艾滋病母婴传播综合干预措施,早检、早发现,为孕产妇及所生儿童提供规范治疗,可减少艾滋病母婴传播发生。

Objective To analyze the effect and its risk factors of the mother-to-child HIV transmission prevention service in Guangxi Zhuang Autonomous Region, to provide scientific basis for the work of mother-to-child transmission in Guangxi. Methods A retrospective analysis was conducted on the case cards of HIV-infected women and their children in Guangxi from 2015 to 2019. The positive rate of HIV antibodies in children born to women with different characteristics was compared by χ~2 test, and the related risk factors were analyzed by Logistic regression model. Results From 2015 to 2019,a total of 2,759 HIV-infected women gave birth in Guangxi, including 2,778 live births. The rate of antiviral drugs for HIV-infected pregnant women, the rate of drug use during pregnancy and the rate of preventive treatment for their children showed an increasing trend, which were 97.29%,92.60% and 99.28% respectively in 2019. The rate of mother-to-child transmission of HIV had fluctuated between 1.51 percent and 3.08 percent, and in 2019 it was 2.08 percent. Multiple factors analysis showed that compared with HIV-infected women during the first trimester, the risk of mother-to-child TRANSMISSION was higher in women during the second trimester(OR=2.115,95%CI:1.151-3.886). Compared with the pregnant women treated with antiviral therapy in early pregnancy, the children born to pregnant women treated in late pregnancy and those not treated in pregnancy were more likely to be infected with HIV(OR=4.321,95%CI:1.655-11.281;OR=15.235,95%CI:6.526-35.569). Preterm infants and children without prophylactic treatment had higher risk of HIV infection than non-preterm infants and children with prophylactic treatment(OR=4.398,95%CI:2.601-7.437;OR=4.708,95%CI:1.780-12.453). Conclusion The prevention of mother-to-child transmission of AIDS in Guangxi continues to improve. The risk factors of mother-to-child transmission are the late gestational age and antiviral treatment, premature delivery and no preventive treatment. We should strengthen propaganda and education, strictly implement comprehensive intervention measures to prevent mother-to-child transmission of AIDS. Early detection and early detection should be applied. Standardized treatment for pregnant women and their children should be provided to reduce the incidence of mother-to-child transmission of AIDS.