2011—2020年芜湖市HIV感染孕产妇母婴阻断情况分析

Analysis on the prevention of mother-to-child in pregnant women infected HIV in Wuhu City from 2011 to 2020

目的分析芜湖市孕产妇HIV感染及母婴阻断情况,为进一步完善HIV感染孕产妇母婴阻断措施提供科学依据。方法通过预防艾滋病、梅毒和乙肝母婴传播管理信息系统收集2011—2020年芜湖市HIV感染孕产妇及所生儿童的相关资料,分析HIV感染孕产妇的检测情况、人群分布特征及母婴阻断干预情况等。结果2011—2020年,芜湖市报告HIV阳性孕产妇50例,平均阳性检出率为16.59/10万。HIV阳性孕产妇平均年龄为(29.54±5.99)岁,以初中文化为主(25例,占50.00%),职业主要为家务及待业(32例,占64.00%)。感染途径多为性传播(28例,占56.00%)。HIV阳性孕产妇中,选择继续妊娠27例(占54.00%),终止妊娠21例(占42.00%),自然流产、失访各1例(各占2.00%);继续妊娠的孕产妇中,接受CD4+T淋巴细胞检测17例(占62.96%),接受病毒载量检测6例(占22.22%),抗病毒用药25例(占92.59%)。选择继续妊娠的孕产妇分娩儿童27例,分娩时均存活,其中儿童抗病毒用药26例(占96.30%);18月龄HIV检测排除感染24例(占88.89%),感染不确定1例,失访2例。结论2011—2020年芜湖市孕产妇HIV检测率、孕产妇和儿童抗病毒用药率均达到国家项目指标要求,今后应进一步提高HIV感染孕产妇的CD4+T淋巴细胞和病毒载量检测率,重点关注临产检测和流动人口孕产妇管理。

Objective To analyze the situation of HIV infection and blocking mother-to-child transmission in pregnant and postpartum women in Wuhu City for scientific evidences to perfect the prevention measures for HIV infection.Methods The relevant data of pregnant women infected with HIV and their children in Wuhu City were retrieved from 2011 to 2020 through the management information system for the prevention of mother to child transmission of AIDS,syphilis and hepatitis B,and then analyzed regarding the HIV related detection,demographic distribution characteristics,and prevention of mother-infant transmission.Results In total,50 women were detected to be positive for HIV from 2011 to 2020 in Wuhu area.The average positive detection rate was 16.59/100000.The average age of pregnant women with positive HIV findings was(29.54±5.99)years.The educational background was primarily associated with junior high school(n=25,50.00%),and the occupation was involved in housewife and unemployment(n=32,64.00%).The main route of infection was from sexual transmission(n=28,56.00%).Twenty-seven women(54.00%)chose to continue pregnancy with informed consent,and 21(42.00%)terminated pregnancy.Spontaneous abortion occurred in 1 case,and another 1 lost the follow-up(2.00%respectively).Among the 27 pregnant women who continued to conceive,17 cases(62.96%)received CD4+T lymphocyte testing,6 cases(22.22%)received virus load testing,and 25(92.59%)were treated with antiviral drugs.Twenty-seven infants were delivered and survived in the 27 women persisting their pregnancy.Twenty-six infants(96.30%)received antiviral drugs and 24(88.89%)were excluded from HIV infection by detection at 18th month.Infection was uncertain in one infant,and another 2 were lost to follow.Conclusion From 2011 to 2020,the HIV testing rate and antiviral drug use rate in the pregnant women and children in Wuhu City have all met the require indicators specified in the national project.In following efforts,it is necessary to further improve the testing rate for CD4+T lymphocyte and viral load in the HIV infected pregnant women,and focus on prenatal testing and management of the pregnant women in the floating population.