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目的探讨抗病毒治疗阻断人类免疫缺陷病毒(HIV)母婴传播的有效性。方法收集妊娠期经酶联免疫吸附试验(ELISA)初筛HIV阳性,并经免疫印迹试验(WB)确诊的11例患者(研究组),给予齐多夫定(AZT)、拉米夫定和奈韦拉平治疗至临产,新生儿第1天开始AZT治疗4~6周,并与13例未抗病毒治疗孕妇(对照组)的母婴结局进行比较。结果研究组平均开始治疗孕周(28.8±5.1)周,平均用药时间(6.1±1.5)个月。研究组治疗后平均HIV DNA载量为(3.5±2.1)×104 copies/ml。两组患者均行剖宫产终止妊娠。研究组新生儿均为HIV阴性,对照组HIV阳性5例,两组比较,差异有统计学意义(P<0.05)。两组均无新生儿窒息。平均随访(1.5±0.8)年,研究组婴儿人工喂养,生长发育正常。对照组13例患儿中,确诊HIV感染5例。两组产妇均未出现严重不良反应。结论对于无过敏反应的HIV阳性孕妇给予抗HIV药物阻断,并选择剖宫产和新生儿人工喂养,可有效阻止HIV母婴传播。
Objective To investigate the effectiveness of antiviral therapy in blocking mother-to-child transmission of human immunodeficiency virus (HIV). Methods Eleven patients (study group) diagnosed with HIV positive by enzyme-linked immunosorbent assay (ELISA) in pregnancy and confirmed by Western blotting (WB) were collected and treated with AZT, lamivudine, Nevirapine treatment until labor, neonatal day AZT treatment 4 to 6 weeks, and 13 cases of non-antiviral treatment of pregnant women (control group) maternal and child outcomes were compared. Results The study group started the treatment of gestational weeks (28.8 ± 5.1) weeks on average, and the average medication time was (6.1 ± 1.5) months. The average HIV DNA load in the study group after treatment was (3.5 ± 2.1) × 104 copies / ml. Two groups of patients underwent cesarean termination of pregnancy. The newborns in the study group were both HIV negative and the control group were HIV positive in 5 cases. There was significant difference between the two groups (P <0.05). No neonatal asphyxia in both groups. The average follow-up (1.5 ± 0.8) years, the study group infants fed, normal growth and development. In the control group, 13 cases were confirmed as HIV infection in 5 cases. Two groups of mothers did not appear serious adverse reactions. Conclusion HIV-positive pregnant women without anaphylaxis were given anti-HIV drugs and cesarean section and neonatal artificial feeding could effectively prevent mother-to-child transmission of HIV.