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目的 了解中国艾滋病病毒1型(HIV-1)母婴传播的现状,特别是母婴传播的发生率和影响因素,为进一步开展预防阻断工作提供背景资料。方法 以地方卫生防疫和医疗机构的哨点监测、产前筛查、日常检测和门诊中发现的HIV-1阳性孕产妇为对象,对其所生子女进行追踪调查和检测。结果 对来自云南、河南、新疆等10个省(自治区、直辖市)的87例HIV-1阳性母亲所生的94名儿童进行追踪,最后追踪到75例母亲及其所生的80名儿童,HIV-1母婴传播发生率为35.0％(28/80)。而河南省的母婴传播率为41.7％(10/24),云南省和新疆维吾尔自治区分别为33.3％(11/33)和27.3％(3/11)。对相关影响因素的分析发现,母亲的感染途径、生产胎次和喂养方式对HIV-1母婴传播有一定的影响作用,其中输血传播、初产和母乳喂养是高危因素。相应的母婴传播率分别为45.5％、39.2％和36.2％,而性传播、多胎生产及人工喂养分别为32.1％、25.9％和22.2％,但差异无显著统计学意义。结论 该研究表明,中国HIV-1母婴传播率与亚非发展中国家相似,而高于西方发达国家。对相关的高危因素(如孕妇的感染途径,特别是输血传播)有必要作进一步地研究。
Objective To understand the status of mother-to-child transmission of HIV-1 in China, especially the incidence and influencing factors of mother-to-child transmission, and to provide background information for further prevention of HIV-1. Methods The targeted immunization and medical institutions sentinel surveillance, prenatal screening, routine testing and outpatient HIV-1-positive pregnant women as the object, their children were traced and tested. Results A total of 94 children from 87 HIV-1 positive mothers from 10 provinces (autonomous regions and municipalities) such as Yunnan, Henan and Xinjiang were followed up, followed by 75 mothers and their 80 children. HIV The incidence of mother-to-child transmission was 35.0% (28/80). While the rate of mother-to-child transmission was 41.7% (10/24) in Henan Province and 33.3% (11/33) and 27.3% (3/11) respectively in Yunnan Province and Xinjiang Uygur Autonomous Region. Analysis of related factors found that the mother’s route of infection, parity and feeding patterns had a certain impact on mother-to-child transmission of HIV-1. Among them, blood transmission, primiparous and breastfeeding were risk factors. The corresponding mother-to-child transmission rates were 45.5%, 39.2% and 36.2% respectively, while the rates of sexual transmission, multiple births and artificial feeding were 32.1%, 25.9% and 22.2% respectively, but the differences were not statistically significant. Conclusions The study shows that the HIV-1 transmission rate in China is similar to those in developing countries in Asia and Africa, but higher than those in western countries. There is a need for further research on the relevant risk factors, such as the route of infection in pregnant women, especially blood transfusions.