MMWR Morb Mortal Wkly Rep. 2002 Feb 8;51(5):93-7.
In 1994, the U.S. Public Health Service (PHS) issued guidelines for maternal and neonatal zidovudine (ZDV) use to reduce perinatal human immunodeficiency virus (HIV) transmission. These guidelines recommend maternal ZDV use during the second and third trimesters of pregnancy and during labor and delivery (L&D) and administration of ZDV to the neonate for the first 6 weeks of life. In 2001, PHS updated 1995 guidelines for routine HIV counseling and voluntary testing of pregnant women. The Michigan Department of Community Health (MDCH) requires reporting of all children who are perinatally exposed to HIV and follows up these children to monitor their infection status and record demographic, clinical, and laboratory characteristics of infected children. The reporting of perinatally HIV-exposed children enables MDCH to monitor the effectiveness of public health efforts to prevent perinatal HIV transmission and assists the targeting of prevention programs and activities. This report summarizes surveillance data collected through December 31, 2001, on children born to HIV-infected women in Michigan during 1993-2000. The report highlights rapid adoption of PHS guidelines that resulted in the reduction of perinatally acquired HIV infection to historically low levels in Michigan. Improving levels of prenatal care (PNC) for HIV-infected pregnant women, especially substance users, and routine HIV counseling and voluntary testing for all pregnant women are needed to further reduce perinatal HIV infection.
1994年,美国公共卫生服务部(PHS)发布了关于孕产妇和新生儿使用齐多夫定(ZDV)以减少围产期人类免疫缺陷病毒(HIV)传播的指南。这些指南建议在妊娠第二和第三个月期间以及分娩期使用ZDV,并在新生儿出生后的头6周内给其使用ZDV。2001年,PHS更新了1995年关于对孕妇进行常规HIV咨询和自愿检测的指南。密歇根州社区卫生部(MDCH)要求报告所有围产期暴露于HIV的儿童,并对这些儿童进行随访,以监测他们的感染状况,并记录受感染儿童的人口统计学、临床和实验室特征。报告围产期暴露于HIV的儿童使MDCH能够监测预防围产期HIV传播的公共卫生措施的有效性,并有助于确定预防项目和活动的目标。本报告总结了截至2001年12月31日收集的关于1993 - 2000年期间密歇根州HIV感染妇女所生儿童的监测数据。该报告强调了PHS指南的迅速采用,这使得密歇根州围产期获得性HIV感染率降至历史最低水平。需要提高对HIV感染孕妇,尤其是药物使用者的产前护理(PNC)水平,并对所有孕妇进行常规HIV咨询和自愿检测,以进一步减少围产期HIV感染。