2015—2019年湖北省预防艾滋病梅毒及乙型病毒性肝炎母婴传播效果分析

Effectiveness of prevention of mother-to-child transmission of HIV,Syphilis,and Hepatitis B in Hubei province,2015—2019

目的探讨2015—2019年湖北省孕产妇艾滋病、梅毒、乙型病毒性肝炎(乙肝)的检测、感染及干预情况,为制定下一阶段的防治措施提供参考。方法利用国家预防艾滋病、梅毒及乙肝母婴传播管理信息系统,收集2015—2019年湖北省孕产妇预防母婴传播项目月报表及相关数据,分析孕产妇艾滋病、梅毒、乙肝不同时期检测率及年度变化趋势以及感染孕产妇所娩儿童的干预情况。结果2015—2019年湖北省孕产妇艾滋病、梅毒及乙肝检测率分别为99.66%、99.36%及99.45%,孕期检测率为85.56%、85.16%及85.29%,5年间3种疾病的检测率和孕期检测率均呈逐年上升的趋势,差异有统计学意义(P<0.05);孕期艾滋病、梅毒及乙肝的阳性检出率分别为1.33‰、1.30‰及5.45%,其中,艾滋病和梅毒的孕期阳性检出率逐年上升,仅产时的阳性检出率分别为1.47‰、2.13‰及8.19%,3种疾病仅产时的阳性检出率逐年上升;艾滋病感染孕产妇所娩儿童用药率在91.67%~95.74%之间波动,梅毒感染孕产妇所娩儿童的预防性治疗率和乙肝表面抗原阳性产妇所娩儿童的免疫球蛋白注射率逐年上升。结论在维持湖北省孕产妇艾滋病、梅毒及乙肝检测率较高水平的情况下,建议进一步提高孕期检测比例、提升产时检测和结果反馈效率、加强对目标人群的健康教育力度以及规范艾滋病、梅毒感染孕产妇及所娩儿童的综合性干预。

Objective To understand the detection,infection and intervention of HIV,syphilis and hepatitis B among pregnant women in Hubei province during 2015-2019,so as to provide reference for the development of prevention and treatment measures in the next stage.Methods Data of monthly reports on HIV,syphilis and hepatitis B prevention from 2015 to 2019 were collected to analyze the detection rate and annual change trend,as well as the intervention situation of the exposed children.Results The detection rates of HIV,syphilis and hepatitis B in pregnant women in Hubei province were 99.66%,99.36% and 99.45% respectively,and the detection rates during pregnancy were 85.56%,85.16% and 85.29% respectively from 2015 to 2019.The detection rate and maternal detection rate of the three diseases increased year by year,and the difference was statistically significant.Positive rates of HIV/AIDS,syphilis,and hepatitis B reached 1.33‰,1.30‰,5.45% respectively,and the positive rate of AIDS and syphilis during pregnancy increased year by year.The positive detection rates at birth were respectively 1.47‰,2.13‰ and 8.19%,the positive detection rates at birth of the three diseases increased year by year.The annual rate of antiviral drugs of children born to HIV-infected mothers fluctuated between 91.59% and 95.74%,the rate of prophylactic treatment and immunoglobulin injection increased year by year in children exposed to syphilis and hepatitis B.Conclusion While maintaining a high level of maternal detection of HIV,syphilis and hepatitis B in Hubei Province,it is suggested to further improve the proportion of maternal detection,improve the efficiency of prenatal testing and result feedback,strengthen health education to target population,and regulate the comprehensive intervention of pregnant women and their children exposed to AIDS and syphilis.