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目的了解母亲在产后输血感染HIV导致的母乳传播及其影响因素,为阻断HIV的母婴传播提供依据。方法以116名产后输血感染HIV的母亲及接受其哺乳的118名子女为研究对象,回顾性调查母乳传播率;分析母亲分娩年龄、子女性别、母亲合并感染HCV、哺乳持续时间、以及母亲哺乳期的乳腺疾病对母乳传播的影响,并探讨HIV母乳传播的危险因素;分析未作抗病毒治疗的情况下,母亲及其子女的生存期。结果 118名接受产后输血感染HIV母亲哺乳的子女,43名HIV阳性,母乳传播率为36.4%。78名母亲和27名HIV阳性子女感染的HIV均为B’亚型;母亲分娩年龄是否大于平均年龄、子女性别、母亲是否感染HCV、母乳喂养时间是否超过12个月均未增加HIV母乳传播率;乳腺疾病增加HIV母乳传播;乳腺疾病及母乳喂养时间是HIV母乳传播的危险因素;母亲的平均生存期为11.8年,HIV阳性子女的平均生存期为12.0年,两者差异无统计学意义(χ2=0.426,P=0.514)。结论母亲在产后输血感染HIV造成的HIV母乳传播率较高,乳腺疾病及母乳喂养时间长促进HIV的母乳传播,通过母乳喂养感染HIV的儿童生存期与其母亲相比差异无统计学意义。
Objective To understand the transmission of breast milk caused by HIV infection in mothers after delivery and its influencing factors, so as to provide a basis for blocking the transmission of HIV from mother to child. Methods A total of 116 postpartum blood transfusions of HIV-infected mothers and their 118 children were enrolled in this study. The rate of breast-milk transmission was retrospectively analyzed. The age, sex, mothers’ co-infected HCV, duration of breastfeeding, Of breast disease on the spread of breast milk and to explore the risk factors for the spread of HIV in the breast; and to analyze the survival of mothers and their children without antiviral treatment. Results Seventy-eight children who were breastfeeding with HIV from postpartum blood transfusions were HIV-positive, with a positive rate of 36.4%. 78 mothers and 27 HIV-positive children were all HIV subtype B; whether the mother’s childbirth was greater than the mean age, sex, mother’s HCV infection or not, and whether breastfeeding was longer than 12 months did not increase the rate of HIV breast-milk transmission ; Breast disease increases HIV transmission of breast milk; breast disease and breastfeeding time are risk factors for transmission of HIV breast milk; the mean survival time of mothers is 11.8 years and that of HIV-positive children is 12.0 years, with no significant difference between the two χ2 = 0.426, P = 0.514). CONCLUSIONS: HIV transmission from mother to mother during post-partum transfusion is associated with a high rate of transmission of HIV breast milk. Breast disease and prolonged breastfeeding promote the spread of HIV. However, there is no significant difference in the survival of children infected with HIV through breastfeeding compared with their mothers.