Rozsypal Hanus
Department of Infectious Diseases, 1st Medical Fakulty, Charles Univerzity of Prague, Czech Republic.
Klin Mikrobiol Infekc Lek. 2006 Apr;12(2):58-62.
Vertical HIV transmission is the main route of infection in children. The vast majority of infected children are born in the developing world. In the developed countries, including the Czech Republic, the situation is relatively favourable thanks to preventive activities and effective prophylactic measures in HIV-positive pregnant women. The risk of vertical transmission depends on a number of maternal (including immunological), virological, obstetric, feto-placental and neonatal factors. The basic prophylactic steps are: administration of antiretroviral agents, delivery by Caesarean section and avoidance of breast-feeding. Diagnosis of HIV infection in children relies on direct virological diagnosis -- the demonstration of the absence of viral genome in blood samples taken at the age of 2-3 and 4-6 months is crucial for excluding vertical infection. In the first 6 weeks of life, children receive the zidovudine prophylaxis. From the age of 6-8 weeks until approx. 6 months, children in whom HIV infection has not been excluded are on the primary co-trimoxazole prophylaxis of Pneumocystis infection.
垂直传播是儿童感染艾滋病毒的主要途径。绝大多数受感染儿童出生在发展中世界。在包括捷克共和国在内的发达国家，由于针对艾滋病毒呈阳性孕妇的预防活动和有效的预防措施，情况相对较好。垂直传播的风险取决于许多母体（包括免疫学）、病毒学、产科、胎儿 - 胎盘和新生儿因素。基本的预防措施包括：给予抗逆转录病毒药物、剖宫产和避免母乳喂养。儿童艾滋病毒感染的诊断依赖于直接病毒学诊断——在2 - 3个月和4 - 6个月时采集的血液样本中未检测到病毒基因组对于排除垂直感染至关重要。在出生后的前6周，儿童接受齐多夫定预防。从6 - 8周龄到大约6个月，未排除艾滋病毒感染的儿童接受针对卡氏肺囊虫感染的复方新诺明初级预防。
