Prevention of Mother-to-Child Transmission of HIV: Experience of a Level 2 Health Center in Senegal

The elimination of vertical transmission of HIV from mother to child is a major global goal. In Senegal, the transmission rate was estimated at 3.2% in 2017. To reduce or even eliminate this transmission, Senegal has implemented various strategies and programs adopted and applied nationally. Thus access to services for the prevention of mother-to-child transmission of HIV has been extended to the level of the health post (the lowest level of the country’s health pyramid) with a delegation of tasks to paramedical staff (nurse, midwife) in the diagnosis and therapeutic management. Objectives: To describe the epidemiological profile of HIV (Human Immunodeficiency Virus)-positive mothers, to assess the care of children born to HIV-positive mothers, to determine the rate of HIV transmission from mother to child. Patients and Method: We carried out a retrospective, cross-sectional and descriptive study of all live newborns of HIV-positive mothers who gave birth at the Gaspard Kamara Health Center (a level 2 health center in Dakar, Senegal) between January 1, 2015 and December 31, 2018. The data were collected from prevention of mother-to-child transmission (PMTCT) prenatal follow-up registers and files, delivery files and registers, and neonatology and pediatric follow-up files, and exploited using the Epi info 7 software. Results: There were 98 children of seropositive mothers. The epidemiological profile of the HIV-positive woman was that of a young woman aged between 16 and 43 with an average of 31.31 years, pauciparous (>65% of cases) from Dakar center (>75% of cases), housewife with a low socio-economic level (63.1% of cases), married in almost all cases, with HIV profile (in almost all cases) and diagnosed before pregnancy (51.02%). The analysis of the children’s data revealed a predominance of girls (52.04%) with a good birth weight (2964g on average) and a pregnancy carried to term in more than 95% of cases. ARV prophylaxis was almost entirely respected with triple therapy (AZT + 3TC + NVP) in a fixed combination as protocol. Protected breastfeeding (80.21%), including 6 months of exclusive protected breastfeeding, was the rule for the mode of feeding. Three children were diagnosed positive with PCR1 as with serology (3.06%). Discussion and Conclusion: the initiatives and strategies put in place in Senegal have enabled a significant reduction in mother-to-child transmission of HIV and deserve to be supported by insisting on primary prevention, programming and good follow-up of pregnancies, and a good support for HIV-positive women.

Evaluation of the Implementation of the WHO’s 2010 Guide on Prevention of Mother To-Child Transmission (PMTCT) of HIV/Aids: Case of Two Hospitals in Yaoundé

Introduction: The prevalence of HIV infection amongst pregnant women in Cameroon is 5.6%. Mother-to-child transmission is a major expansion factor. In 2010, Cameroon adopted new strategies pegged to WHO guidelines. Objectives: The objective of this study was to evaluate the implementation of the new guidelines of prevention of mother to-child transmission (PMTCT) of HIV in the Yaoundé Central Hospital and the Yaoundé Teaching Hospital. Methodology: It was a cross sectional descriptive and prospective study over a period of 6 months in Yaoundé. It included all HIV-positive women, doing their antenatal care in the above cited hospitals, and having given their consent. The studied variables included socio demographic features, obstetrical history, the antenatal care, the initiation of anti retroviral (ARV) drugs, the ARV regimen, the number of years on ARV drugs, the mode of delivery and the mother and child outcome. The data was collected using a pre-tested questionnaire. They were obtained by interview of the seropositive pregnant women. Data were analysed using Epi info 3.5.3. Results: We performed 3104 antenatal consultations and 287 women were recruited in the study. The prevalence of HIV infection was 9.24%. The mean age of women was 28.77 (SD: 5.13) years. The women were aged between 20 and 29 years in 51.20%. Amongst the 156 women who knew their status before pregnancy, 109 (70.50%) had their first ANC in the first trimester. All were managed according to the 2010 WHO recommendations on PMTCT of HIV. Amongst the women unaware of their status, 25.20% had their booking ANC in the first trimester, 25.14% started ARVs at 14 weeks, 69.46% at 28 weeks. We had 125 live births, 84.8% by vaginal route, neonatal prophylaxis in all babies was effective. Conclusion: PMTCT of HIV is available and guidelines are well applied in Yaoundé. Late treatment initiation still remains a problem to optimize care.

Evaluating the Knowledge of HIV Transmission and Prevention of Mother to Child Transmission (PMTCT) of HIV among HIV-Positive Mothers Accessing Care in Military Hospital in Lagos, Nigeria

Introduction: The prevention of mother-to-child transmission (PMTCT) plays a major role in limiting the number of children being infected by HIV. There is dearth of studies that explored the knowledge of HIV transmission and PMTCT among women living with HIV. Methods: This was a cross-sectional, descriptive study of HIV-positive mothers receiving medical care at the adult antiretroviral therapy (ART) clinic, 68 Nigeria Army Reference Hospital Yaba. A pre-tested structured questionnaire was used to collect information from the subjects concerning their socio-demographic, knowledge of HIV transmission and mother-to-child transmission of HIV and preventive measures. SPSS v23 was used for data analysis. Results: Out of the 374 participants, 282 (75.4%) were aware that HIV can be transmitted to an unborn baby from the positive mother. Of these, 240 (85.1%) were well-informed that increase mother’s viral load can increase the chances of mother-to-child transmission. 268 (95%) understood that giving of antiretroviral drugs during and after pregnancy can lower transmission risk, while 254 (90.1%) saw the use of breast milk substitutes as another prevention strategy. There was statistically significant association between the respondents’ knowledge of PMTCT and their husbands’/partners’ awareness of their HIV status. Conclusion: In conclusion, our study demonstrated a good knowledge of HIV transmission, MTCT and PMTCT among women who were receiving ART in our centre. Disclosure is a significant factor found to be associated with PMTCT knowledge. More studies can also explore if the observations in our study with women living with HIV will be comparable in similar population in different settings.

Missed Prevention of Mother-to-Child Transmission of HIV (PMTCT) Visits and Associated Programmatic Predictors: A Pilot Study

Missed Prevention of Mother-to-Child Transmission of HIV (PMTCT) visits have contributed to the delayed achievement of elimination of mother-to-child transmission of HIV. Missed visits promote attrition from prevention of mother-to-child transmission of HIV program and antiretroviral drug resistance. The purpose of the study was to determine the prevalence of missed PMTCT visits and its associated predictors. A descriptive cross sectional survey was carried out at a District Hospital in Goromonzi, Zimbabwe. Fifty-three women completed closed-ended questionnaires pertaining to PMTCT visits and exposure to PMTCT activities. A total of 24.5% missed at least one scheduled PMTCT visit. Statistically significant predictors of not missing a PMTCT visit were satisfaction with family support (β = −0.73, p = 0.029) and level of satisfaction with PMTCT services (β = −0.00076;p = 0.04). The number of days by which scheduled visits were missed were inversely correlated with visit number (β = −2.99, p = 0.04). Enhanced family support and quality improvement to improve patient satisfaction may reduce missed visits. Availing women with a more active role in PMTCT may also reduce the prevalence of missed visits.

Beliefs and practices of young women on utilization of prevention of mother to child transmission of HIV services in Malawi

This study explored beliefs and actual practices of young women on utilization of Prevention of Mother to Child Transmission (PMTCT) of HIV services in Balaka district of Southern Malawi. The study design wascross sectional which utilized qualitative data collection and analysis methods. In-depth interviews were conducted on 12 young mothers of 15 to 24 years old. The respondents were drawn from 6 health centres in the district during their visits to either the under-five clinic, HIV and AIDS support groups or HIV follow up clinics. Data were analyzed using thematic analysis approach. Overall the respondents had positive beliefs on utilization of PMTCT services. They believed that adherence to PMTCT guidelines such as condom use, taking of Nevirapine (NVP) and exclusive breastfeeding protected the baby from contracting the virus. Nevertheless, all respondents believed that HIV testing was mandatory and that early weaning caused malnutrition and death of babies. Actual practice was very low. Very few young mothers breastfed exclusively, weaned their babies abruptly and took NVP as recommended. Not all positive beliefs translated into positive behavior. Lack of male support, inability of the midwives to provide comprehensive care to HIV infected mothers and their infants, and fear of stigma and discrimination were other factors that hindered utilization of PMTCT services. Culture was also a major barrier because traditionally babies are expected to be breastfed and supplements are fed to babies too. Therefore, there is a need to mobilize communities on PMTCT of HIV. Education programmes in HIV should emphasize behavior change interventions and should focus on both men and women and significant others. There is also need to intensify monitoring and evaluation of health workers’ activities to ensure that beliefs translate into positive behavior.

一孩感染乙肝孕妇二孩妊娠的母婴阻断研究

目的探讨乙肝孕妇一孩母婴阻断失败的原因及二孩妊娠阻断效果和母婴结局,评价妊娠期抗病毒治疗阻断乙型肝炎母婴传播对儿童生长发育的影响。方法选取2017年2月至2019年2月南京中医药大学附属南京医院产科常规产检的34例HBV感染经产妇。HBV感染孕妇一孩妊娠时均未抗病毒治疗为一孩组;二孩妊娠时均在妊娠中晚期开始抗病毒治疗为二孩组,比较两次妊娠期合并症及并发症的发生率。两次分娩新生儿分为新生儿一孩组及新生儿二孩组,比较一般情况、患病情况及生长发育。结果34例孕妇两次妊娠期间均为HBeAg阳性,分娩一孩前平均HBV-DNA为(2.27±1.95)×10^(8)IU/mL,二孩妊娠后孕妇平均HBV-DNA水平为(2.43±2.15)×10^(8)IU/mL。二孩组分娩前口服抗病毒药物孕妇病毒载量均下降,平均下降至(1.98±6.23)×10^(3)IU/mL。二孩组孕妇剖宫产率高于一孩组孕妇(P=0.005)。一孩组孕妇出现妊娠合并症、产时并发症发生率与二孩组差异无统计学意义(P>0.05)。新生儿一孩组新生儿出生后规范的乙肝疫苗接种率为70.59%(24/34),规范的乙肝免疫球蛋白接种率为50%(17/34)。新生儿二孩组新生儿乙肝疫苗及免疫球蛋白接种率和及时率高于新生儿一孩组(P<0.05)。两组新生儿出生缺陷、生长发育差异没有统计学意义(P>0.05)。结论高病毒载量孕妇孕期抗病毒治疗可有效降低病毒载量,联合新生儿免疫接种可以减少新生儿乙肝病毒感染的发生。妊娠期抗病毒治疗不会增加围生期不良事件和产时并发症的发病率,也不影响新生儿的生长发育。

中国乙型肝炎病毒母婴传播防治指南(2024年版)

中华医学会感染病学分会制定的《中国乙型肝炎病毒母婴传播防治指南(2019年版)》(简称2019版《指南》)对国内乙型肝炎病毒母婴传播阻断流程的规范化起到了良好的指导作用。临床实践指南和共识需要随新研究证据的出现,及时更新以更好地指导临床实践和研究。中国医师协会感染科医师分会和中华医学会感染病学分会联合多学科专家,基于国内外最新研究进展,结合临床实践,对2019版《指南》进行了更新和补充,为临床医师和妇幼保健工作人员提供指导和参考。

接受母婴阻断治疗的慢性HBV感染孕妇产后肝炎发作的风险预测模型构建

目的:探讨慢性HBV感染孕妇以母婴阻断为目的抗病毒治疗产后肝炎发作的危险因素并构建风险预测模型。方法:纳入2020年1月至2022年10月在上海市公共卫生临床中心产检及分娩的198例慢性HBV感染孕产妇,随访至产后48周,根据随访结束时患者是否肝炎发作,将患者分为肝炎发作组40例(肝炎发作组)和未发作组158例(对照组)。基于两组患者的一般临床资料和开始抗病毒前血清丙氨酸氨基转移酶(ALT)、乙肝病毒DNA定量(HBV DNA)、乙肝表面抗原(HBsAg)、乙肝e抗原(HBeAg)及乙型肝炎病毒核心相关抗原(HBcrAg)定量水平,分析慢性HBV感染孕妇抗病毒治疗产后肝炎发作的危险因素,并构建风险预测模型。结果:肝炎发作组与对照组开始抗病毒前血清ALT、HBcrAg、HBsAg、HBeAg及HBV DNA水平比较,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,抗病毒前较高的血清HBcrAg、HBsAg、HBeAg及HBV DNA水平是影响慢性HBV感染孕产妇产后肝炎发作的独立危险因素(P<0.05)。这些独立危险因素对产后肝炎发作有良好的预测价值,且四者联合诊断预测价值更高(AUC=0.953)。结论:联合检测开始抗病毒前血清HBcrAg、HBsAg、HBeAg及HBV DNA水平对慢性HBV感染孕产妇产后肝炎活动有良好的预测意义,可为临床随访和决策提供参考。

基于临床实践指南/专家共识的乙型肝炎预防策略知识图谱构建

目的探讨不同人群乙型肝炎(乙肝)预防策略之间的关联,为乙肝预防的决策制定和实践提供科学依据。方法检索国内外乙肝指南和专家共识,提取乙肝预防推荐意见并抽取实体、关系和属性数据,利用Python的py2neo库调用数据,将其导入Neo4j图数据库中构建可视化知识图谱。结果检索8个数据库和12个官方网站,共获得中文指南6部、专家共识2部,英文指南16部、专家共识2部,提取了260条预防相关推荐意见。根据推荐意见抽取得到适用人群、特殊人群、检测类操作、干预类操作、药物大类、具体药物名称、时机和推荐程度共8种实体,以及操作选择、最佳操作时间、用药选择、用药时间、进行和包含共6种关系,最终构建了筛查、疫苗接种、母婴阻断、管理策略和暴露后预防共5个知识图谱,为不同人群提供相应的乙肝预防策略。结论乙肝预防策略知识图谱的构建有助于医疗工作者和公众更好地了解乙肝预防措施,为决策者制定更具针对性和有效性的乙肝防控策略提供科学依据,促进乙肝防控工作的全面展开和持续发展。

基于PMTCT模式的梅毒母婴传播控制效果

目的探讨基于预防传染性疾病母婴传播(PMTCT)模式的梅毒母婴传播控制效果。方法选取10600例于我院进行产检的孕妇作为研究对象,根据产检时间将2018年1月至9月的5300例孕妇设为研究组(基于PMTCT模式管理),将2016年1月至9月的5300例孕妇设为参照组(常规模式)。比较两组的管理效果。结果研究组与参照组的妊娠合并梅毒孕妇分别为17、16例。研究组规范治疗率高于参照组,不良妊娠结局总发生率低于参照组(P<0.05)。结论基于PMTCT模式管理对梅毒母婴传播控制效果显著。

Research Progress of Related Laboratory Testing Indexes before and after Mother-Infant Blocking in HIV/AIDS Pregnant Women

More than 90% of HIV-positive children come from mother-to-child transmission, so mother-to-child interdiction is the main measure to prevent AIDS in children. Relevant data show that the incidence of mother-to-child transmission of HIV usually fluctuates between 15% and 50% without intervention. Standardized and effective comprehensive intervention can reduce the transmission rate of mother to child to less than 1%. At present, it is believed that mother-to-child transmission of AIDS can be blocked by comprehensive intervention, and its mechanism has been clearly studied. Combined with highly effective antiviral treatment, safe labor and artificial feeding, the mother to child transmission rate can be reduced to less than 1%. However, due to the effect of drugs on mother-to-child transmission of AIDS may lead to some changes in the main biochemical indicators of mother-to-child, there is no systematic analysis of the viral load, T lymphocyte subsets and major biochemical indicators of HIV/AIDS pregnant women before and after maternal-to-child transmission. In this study, the viral load, T lymphocyte subsets and major biochemical indicators of HIV/AIDS pregnant women before and after maternal-infant blockade were dynamically analyzed. It is hoped that this study will help to observe the basic physical fitness and disease development of pregnant women with HIV/AIDS during pregnancy, to provide a strong basis for the treatment and evaluation of maternal-infant blockade of HIV/AIDS pregnant women, and to establish a complete set of laboratory indicators to understand the body status of pregnant women at all stages to minimize the probability of fetal transmission, which will make good economic and social benefits.

母婴阻断中抗乙型肝炎病毒药物核苷(酸)类似物的治疗进展

母婴传播是乙型肝炎病毒(hepatitis B virus,HBV)传播的主要途径之一,也是HBV感染后慢性化的主要原因,因此,阻断HBV母婴传播对于降低慢性乙型肝炎发病率尤为重要。目前,用于HBV母婴阻断的核苷(酸)类似物(Nas)有拉米夫定、替比夫定、富马酸替诺福韦二吡呋酯,富马酸丙酚替诺福韦亦开始用于妊娠期慢性乙型肝炎患者。该文总结上述药物在HBV母婴阻断中的疗效、安全性以及抗病毒治疗指征和停药时间,为母婴阻断Nas的选择及合理应用提供参考。

免疫预防乙型肝炎病毒母婴传播与乙肝疫苗接种的价值

为探究免疫预防乙型肝炎病毒母婴传播与乙肝疫苗接种的价值,选取肃宁县人民医院2020年1月—2023年1月收治的220例乙肝表面抗原(Hepatitis B surface antigen,HBsAg)阳性孕妇与其新生儿作为研究对象,采用问卷的形式对孕妇乙肝免疫球蛋白(Hepatitis B immunoglobulin,HBIG)使用情况与新生儿免疫方式进行调查,同时对新生儿乙肝血清标志物进行检测。220例HBsAg阳性孕妇与其新生儿中,41例(18.63%)注射过HBIG,179例(81.37%)未注射过HBIG,单纯接种乙肝疫苗的例数为34例(15.45%),HBIG联合乙肝疫苗接种的例数为186例(84.55%)。注射组、未注射组的新生儿HBsAg阳性率分别为4.88%与3.35%,数据并无统计学意义(P>0.05);单纯组与联合组的新生儿HBsAg阳性率则分别为17.65%、2.69%,差异存在统计学意义(P<0.05)。研究发现,HBIG注射联合乙肝疫苗接种,可有效阻断乙型肝炎病毒的传播,进而降低新生儿感染率,临床实践意义突出。

感染HIV的孕产妇预防艾滋病母婴传播服务需求与障碍分析

目的了解艾滋病病毒(HIV)感染孕产妇的预防艾滋病母婴传播服务需求与服务利用障碍。方法对某艾滋病高发地区,自2003年以来截至2004年10月发现并分娩的HIV感染孕产妇进行问卷调查。结果13.79%的孕产妇不愿意接受产前检查,5.17%的孕产妇不愿意住院分娩,怕歧视、担心检查和住院分娩费用高等是孕产妇不接受孕产期保健的主要原因;96.43%的孕产妇愿意本人和给孩子服用抗逆转录病毒药物预防艾滋病母婴传播,但只有87.50%的孕产妇服用了抗HIV药物,未服药的原因为临产急诊分娩,未得到检测结果,延误了孕产妇和婴儿的服药时机;89.29%的孕产妇希望其所生婴幼儿获得随访服务,但只有58.93%的婴幼儿得到过随访服务,其中51.52%的婴幼儿在出生后3个月内得到首次随访;怕别人知道自己的感染情况是不愿意接受随访的主要原因;近7%的孕产妇不愿意或不知道要给所生的婴幼儿进行HIV抗体检测。结论育龄妇女和孕产妇艾滋病检测不及时、非住院分娩、婴幼儿随访服务薄弱、经济负担、社会歧视等问题,是预防艾滋病母婴传播服务利用的主要障碍,预防艾滋病母婴传播综合能力亟待加强。

我国HIV感染孕产妇妊娠、分娩及婴儿喂养方式的meta分析

目的了解2003~2011年我国人类免疫缺陷病毒（human immunodeficiency virus,HIV）感染孕产妇的继续妊娠率、剖宫产率及其所生婴儿的人工喂养率情况,为艾滋病母婴传播的预防工作提供参考。方法计算机检索PubMed、Web of Science、The Cochrane Library、中国期刊全文数据库（CNKI）、中文科技期刊数据库（VIP）、万方数据库（WanFang Data）和中国生物医学文献数据库（CBM）,检索时间从建库至2013年5月,纳入国内外公开发表的关于我国HIV感染孕产妇继续妊娠、剖宫产及其所生婴儿人工喂养情况的文献。由2名研究者独立筛选文献、提取资料并评价质量。采用Comprehensive MetaAnalysis Version2.0软件进行meta分析。采用meta回归分析方法探讨异质性的来源。结果共检索到2 356篇文献,最终纳入61篇。Meta分析结果显示,2003~2011年,我国HIV感染孕产妇的继续妊娠率依次为67.50%[95%CI（51.73%,80.10%）]、60.49%[95%CI（18.59%,91.13%）]、51.80%[95%CI（28.13%,74.68%）]、62.59%[95%CI（54.60%,69.96%）]、64.93%[95%CI（50.18%,77.29%）]、70.65%[95%CI（62.20%,77.88%）]、65.66%[95%CI（59.70%,71.16%）]、67.85%[95%CI（52.66%,80.02%）]、75.00%[95%CI（59.46%,85.99%）];2004~2010年HIV感染孕产妇的剖宫产率依次为26.33%[95%CI（9.41%,55.14%）]、43.40%[95%CI（34.30%,52.96%）]、42.57%[95%CI（35.73%,49.70%）]、69.43%[95%CI（13.48%,97.07%）]、46.68%[95%CI（27.27%,67.16%）]、61.14%[95%CI（49.37%,71.75%）]、56.60%[95%CI（36.36%,74.85%）];2004~2010年HIV感染孕产妇所生婴儿人工喂养率除2005年为82.65%[95%CI（69.07%,91.04%）]以外,其余年份均达90.00%以上。结论近年来我国HIV感染孕产妇继续妊娠率总体上升;剖宫产率较高,波动较大且仍在上升;HIV感染孕产妇所生婴儿人工喂养率稳定在较高水平。

感染HIV的孕产妇预防艾滋病母婴传播服务利用及影响因素分析

目的了解感染艾滋病病毒(HIV)的孕产妇对预防艾滋病母婴传播(PMTCT)服务的利用状况,分析影响因素。方法在河南、广西、新疆、云南省(自治区)的15个县/市/区,对2004年1月至2006年6月检测发现的感染HIV的孕产妇346人,通过问卷调查方式,结合相关医疗记录在孕期、产时和产后分阶段完成调查。调查内容包括人口学特征、相关行为、感染途径、PMTCT服务的利用情况等。结果346名感染HIV的孕产妇中94.80%接受过产前检查,95.95%住院分娩,其希望住院分娩的原因是医院医疗技术水平高(58.28%),服务质量好(47.27%),收费低(33.33%),能够提供PMTCT服务(33.03%),保密性好(26.97%),交通方便(23.33%)等。87.57%的母婴应用抗艾滋病病毒药物,规范应用抗病毒药物者占46.82%。感染HIV的孕产妇所娩婴儿中,89.02%采取人工喂养方式,满18月龄时进行HIV检测者占93.75%。检测后咨询包含PMTCT内容、民族和文化程度对规范应用抗病毒药物有影响作用(P<0.05)。结论感染HIV的孕产妇对PMTCT服务的需求特殊,PMTCT服务利用尚不足,检测后咨询及咨询内容影响抗病毒药物的规范应用。建议加强HIV/ADIS高发地区基础妇幼保健服务,提高妊娠妇女早期和孕中期HIV抗体检测水平,重视感染HIV孕产妇抗病毒药物的规范应用和安全助产,为感染HIV的孕产妇及所娩婴儿提供个性化的、综合的PMTCT服务。

艾滋病感染孕产妇15例母婴阻断综合干预措施探讨

目的分析人类免疫缺陷病毒(HIV)阳性孕产妇感染现状,探讨艾滋病母婴阻断综合干预措施。方法对2007年4月至2013年4月芜湖市随访管理的15例艾滋病感染孕产妇个案表、孕产期检查结果、阻断用药和婴儿随访个案表进行回顾性分析。结果 15例HIV阳性孕产妇均接受母婴阻断咨询干预,选择终止妊娠6例,占40.0%;选择继续妊娠9例,占60.0%。9例婴儿存活率和人工喂养率均100.0%,其中7例满18个月艾滋病抗体检测结果为阴性,7例随访已结案的阻断成功率为100.0%;2例未满12个月仍在随访中。丈夫检测HIV阳性3例,占20.0%;阴性10例,占66.7%,未检测2例,占13.3%。孕产妇本次妊娠在医院人流、引产或分娩时受到歧视6例,占40.0%。结论外来妇女筛查、婚检和产检HIV筛查能尽早发现HIV阳性孕产妇,良好的沟通和关怀是随访管理的关键,采取孕产期综合干预措施能有效降低艾滋病母婴传播发生率。

5省艾滋病高发地区HIV感染孕产妇应用抗逆转录病毒药物影响因素分析

目的了解HIV抗体咨询与检测对孕产妇应用抗逆转录病毒药物依从性的影响。方法 2006年1月至2010年12月在全国艾滋病相对高发地区的23个市/县/区开展艾滋病母婴传播队列研究。对1414名HIV感染孕产妇及所生儿童的人口学特征、应用抗逆转录病毒药物方案、孕产妇接受预防艾滋病母婴传播自愿咨询与检测服务的情况进行问卷调查。结果 1414名HIV感染孕产妇中,有1120名(79.77%)感染孕产妇接受了抗逆转录病毒药物,有87.69%儿童应用了抗逆转录病毒药物。将单因素中对用药产生影响的变量纳入多因素Logistic回归模型,结果显示,接受过检测前、后咨询服务的HIV感染孕产妇应用抗逆转录病毒药物的比例分别是未接受过检测前、后咨询者的1.99倍和3.08倍(OR=1.99,95%CI:1.37～2.89;OR=3.08,95%CI:1.16～8.20)。若HIV感染孕产妇是既往感染者,则其接受抗逆转录病毒药物的可能性较大(OR=4.11,95%CI:2.72～6.20)。结论提高HIV抗体检测咨询覆盖和服务质量,有助于提高HIV感染孕产妇对抗逆转录病毒药物的应用。

HIV母婴传播阻断综合措施与效果评价

目的分析妊娠合并人类免疫缺陷病毒(HIV)感染孕产妇实行综合性母婴阻断措施的效果。方法回顾性分析北京地坛医院2003年至2017年81例合并HIV感染的孕产妇实行综合性阻断措施后,新生儿感染HIV的情况。结果经过艾滋病母婴传播阻断综合干预后,81例孕产妇中有10例在知情同意后选择终止妊娠,纳入母婴阻断服药的人数为71例。71例合并HIV感染的孕产妇中,流产7例次,生产65例次,65例新生儿均进行了新生儿药物阻断,阻断成功率为100.0%。结论对HIV感染的孕产妇进行综合性母婴传播阻断措施,可以很大程度上降低HIV的母婴传播率,控制新生儿艾滋病流行。

艾滋病高流行地区预防母婴传播资源投入与分配分析

目的：分析艾滋病高流行地区预防母婴传播资源投入与分配现状。方法：收集我国4个HIV相对高流行地区2003～2006年预防艾滋病母婴传播资源投入与流向构成,分析资源投入与当地女性HIV新发感染水平和预防措施覆盖面之间的关系。结果：研究地区预防艾滋病母婴传播资源投入逐年增长,能力建设和干预措施的支出占总投入的90%,各年间资源流向构成差异有显著性（P〈0.001）,孕产妇HIV抗体检测率逐年增加。结论：随女性HIV新发感染水平的增加,预防母婴传播资源投入增加,干预措施覆盖面扩大,但资源分配尚未形成成熟模式。