Zhuang Ke, Gui Xi-en, Luo Jia-la, Wang Xiao-rong, Su Bo, Zhang Yong-xi
Department of Infectious Diseases, Zhongnan Hospital, Wuhan University, Wuhan 430071, China.
Zhonghua Er Ke Za Zhi. 2003 Aug;41(8):586-9.
To estimate prevalence of HIV/AIDS among children and the transmission routes in a highly endemic villages of AIDS.
Totally 208 high-risk women of child bearing age and 159 of their children aged 0 - 14 years were investigated. Their medical histories of blood donation or transfusion were collected, blood samples were taken and sera were separated for HIV test. Enzyme-linked immunosorbent assay (ELISA) and Western blot assay were performed for HIV antibody. The Nested-polymerase chain reaction (PCR) assay amplifying gag gene p17 was performed on samples of children aged less than 18 months.
Thirty-seven HIV infected cases were found among 159 children aged 0 - 14 years of whom 33 were infected by mother-to-child transmission (89.2%, 33/37), 3 by blood transfusion (8.1%, 3/37) and one by iatrogenic route (2.7%, 1/37). Sixty seven mothers who were seropositive for HIV and their 86 children who were born after 1992 were investigated, 33 cases of them were infected with HIV. The rate of vertical transmission was 38.4% (33/86). The HIV vertical transmission rate among mothers with AIDS (68.8%, 22/32) was significantly greater than that among mothers with asymptomatic HIV infection (20.4%, 11/54, P < 0.05). The number of children infected with HIV through vertical transmission increased from 1993 to 2001. Among 37 children infected with HIV, 12 cases developed AIDS and 4 of them died, of whom 2 cases died from tuberculosis. The morbidity of AIDS was 27.3% (9/33). Ninety three point nine percent (31/33) of infected mothers didn't know their HIV seropositive status before pregnancy and delivery. Of 8 pregnant women infected with HIV, one had aggravation of AIDS, 2 miscarried, 2 terminated their pregnancy and 3 continued their pregnancy.
Mother-to-child transmission of HIV was the major route of HIV/AIDS transmission to the children. The main reason leading to HIV infection in children was the lack of prenatal HIV counseling and testing for the high-risk women of childbearing age and lake of interventions. The countermeasures must be taken to control the further transmission of AIDS in order to protect the health of women and children in the highly endemic areas of AIDS.
评估艾滋病高度流行村庄中儿童感染艾滋病毒/艾滋病的患病率及其传播途径。
对208名高危育龄妇女及其159名0至14岁的子女进行调查。收集她们的献血或输血病史，采集血样并分离血清进行艾滋病毒检测。采用酶联免疫吸附试验（ELISA）和免疫印迹法检测艾滋病毒抗体。对18个月以下儿童的样本进行巢式聚合酶链反应（PCR）检测，扩增gag基因p17。
在159名0至14岁儿童中发现37例艾滋病毒感染病例，其中33例通过母婴传播感染（89.2%，33/37），3例通过输血感染（8.1%，3/37），1例通过医源性途径感染（2.7%，1/37）。对67名艾滋病毒血清学阳性的母亲及其1992年以后出生的86名子女进行调查，其中33例子女感染了艾滋病毒。垂直传播率为38.4%（33/86）。艾滋病母亲的艾滋病毒垂直传播率（68.8%，22/32）显著高于无症状艾滋病毒感染母亲（20.4%，11/54，P<0.05）。1993年至2001年，通过垂直传播感染艾滋病毒的儿童数量有所增加。在37例感染艾滋病毒的儿童中，12例发展为艾滋病，其中4例死亡，2例死于结核病。艾滋病发病率为27.3%（9/33）。93.9%（31/33）的感染母亲在怀孕和分娩前不知道自己的艾滋病毒血清学阳性状态。8名感染艾滋病毒的孕妇中，1例艾滋病病情加重，2例流产，2例终止妊娠，3例继续妊娠。
艾滋病毒母婴传播是儿童感染艾滋病毒/艾滋病的主要途径。导致儿童感染艾滋病毒的主要原因是高危育龄妇女缺乏产前艾滋病毒咨询和检测以及缺乏干预措施。必须采取对策控制艾滋病的进一步传播，以保护艾滋病高度流行地区妇女和儿童的健康。
