Recommend Guideline on Prevention of Mother-to-Child Transmission of HIV in China in 2020

In China, a pilot project for the prevention of mother-to-child transmission (PMTCT) of the HIV was initiated in 2001. For the PMTCT of HIV, the Chinese government has released versions of the guidelines since 2004. In 2014, the World Health Organization released guidance on global processes and criteria for the validation of elimination of mother-to-child transmission of HIV and syphilis. To promote the elimination of mother-to-child transmission of HIV, syphilis, and hepatitis B virus in China, the Chinese government updated the Guideline for PMTCT of HIV, Syphilis, and Hepatitis B in 2020 (briefly as Guideline-2020). The Guideline-2020 comprises 5 parts: goals, interventions, support measures, duties and cooperation of departments, and definition indicators for PMTCT of HIV and corresponding calculation formulas. Compared with the previous versions, the key points updated in the Guideline-2020 are that the goals are set again, and health education and promotion, the procedure of HIV testing for pregnant women, and the antiretroviral therapy regimen for HIV-positive pregnant women and antiretroviral) prophylaxis regimen for infants are all updated. The antiretroviral prophylaxis regimen as zidovudine-lamivudine-nevirapine/lopinavir/ritonavir twice per day for 6 weeks is recommended for infants at high exposure risk to HIV, whereas the third antiretroviral therapy regimen as tenofovir-lamivudine-lopinavir/ritonavir is recommended for HIV-positive pregnant women, and indicators for PMTCT of HIV and corresponding calculation formulas are defined.

Screening and Treatment of Syphilis for Pregnant Women—China,2011−2018

What is already known on this topic?The national program of prevention of mother-to-child transmission(PMTCT)of syphilis was initiated in 2011 and scaled to a national level since 2015.A better understanding of the implementation and outcomes of the program on PMTCT of syphilis is needed for future strategies to achieve the World Health Organization(WHO)goal of elimination of motherto-child transmission(EMTCT)of syphilis.What is added by this report Between 2011 and 2018,as the coverage of syphilis screening of pregnant women and treatment for syphilis-seropositive pregnant women and their infants have increased consistently,the incidence of congenital syphilis was significantly reduced from 91.6 cases per 100,000 live births to 18.4 cases per 100,000.Treatment rates and adequate treatment rates of syphilis-seropositive pregnant women were below the criteria of validation of EMTCT of syphilis and regional disparities were found.What are the implications for public health practice?We recommend continuing to strengthen the current PMTCT intervention strategies with further commitments to achieve the targets set by the WHO’s dual EMTCT of HIV and syphilis.Barriers to achieving high coverage of adequate treatment should be investigated and addressed at the provincial level to ensure prompt treatment for syphilis-seropositive pregnant women.

Incidence of persistent and high-risk human papillomavirus infection and associated factors among HIV-positive women in China, 2015-2016

Background:Persistent human papillomavirus(HPV)infection is the necessary factor for cervical cancer.Human immunodeficiency virus(HIV)-positive women are a high-risk population for cervical cancer,but little is known about persistent HPV infection among HIV-positive women in China.We aimed to investigate the persistence and incidence of infection with high-risk HPV(hrHPV)and associated factors among HIV-positive women in China.Method:Using a prospective observational study design,we collected data from 670 HIV-positive women in five counties of three provinces through interviews,medical record reviews,health examination,and laboratory tests at a baseline survey in 2015 and a follow-up survey in 2016.We tested HIVpositive women for hrHPV infection using the Cobas 4800 HPV test,and analyzed factors associated with persistence and new incidence of hrHPV infection using logistic regression.Results:After an average of 15 months at follow-up,the persistence and new incidence rates of hrHPV infection were 38.0%(46/121,95%CI:29.2%-46.8%)and 8.3%(35/420,95%CI:5.7%-11.1%),respectively.HIV-positive women in Yunnan and Guangxi were more likely to have persistent hrHPV infections than those in Xinjiang(aOR=3.18,95%CI:1.00-10.14,p=0.05;aOR=6.38,95%CI:2.29-17.77,p<0.001).Migrant women had a higher rate of new hrHPV incidence than local women(aOR=4.48,95%CI:1.65-12.15,p=0.003).HIV-positive women from Xinjiang were 6.5 times more likely to be newly infected with hrHPV than those from Yunnan(95%CI:2.40-17.60,p<0.001).HIV-positive women with HBV infection had a higher risk of being infected with hrHPV than those without HBV infection(aOR=3.48,95%CI:1.13-10.71,p=0.029).Conclusions:The persistence and new incidence rates of hrHPV infection among HIV-positive women were high and varied significantly between regions.HBV infection and being among the migrant population were associated with new hrHPV infection.

Detection and Associated Factors for Cervical Precancerous Lesions Among HIV-Positive Women from High HIV-Burden Areas — China, 2015−2016

Summary What is already known about this topic?Cervical cancer is one of the most common cancers among HIV-positive women.The World Health Organization(WHO)has recommended a program of cervical cancer screening for HIV-positive women.Prospective follow-up studies and specific recommendations on cervical cancer screening for HIV-positive women in China are not currently being performed.