Rozsypal Hanus, Stanková Marie, Machala Ladislav, Brucová Marie
Department of Infectious Diseases, 1st Medicine Faculty of Charles University Prague, Czech Republic.
Klin Mikrobiol Infekc Lek. 2006 Apr;12(2):63-8.
To assess the efficacy of prophylactic measures intended to reduce vertical transmission of HIV infection and to evaluate the predictive value of demographic, immunological and virological factors for determination of the risk of HIV transmission to fetus and neonate.
56 pregnancies of 53 HIV-positive women were included in this retrospective study. The women have been in the care of the AIDS Centre of the Dpt. of Infectious Diseases, University Hospital Na Bulovce over the past 15 years. Cellular immunity tests and HIV RNA viral load in all subjects were regularly determined. In line with our present knowledge and the patients compliance, we introduced prophylactic measures, which included the administration of antiretroviral agents, delivery by Caesarean section and breast-feeding avoidance. 58 children were born from these pregnancies and repeated blood tests were performed to detect the presence or absence of HIV RNA.
58 infants were born from 56 pregnancies-and 3 of them (5.17%) were infected with HIV. In two mothers, we diagnosed HIV positivity few hours before delivery; another woman was diagnosed early, however, the failure of treatment was due to her insufficient compliance. In addition, premature amniorrhoea was present in two women. Moreover, one of them presented with untreated syphilis. The other 55 children stayed uninfected. In six of them, however, prophylactic measures were not fully followed, mainly because the patients disregarded them.
The study fully confirms the high efficacy of prophylactic measures, which substantially reduce the risk of vertical transmission of HIV infection. Routine blood tests are necessary in all pregnant women by law. The failure of prophylaxis is in most cases due to inadequate compliance with the treatment. However, we cannot rule out the possible resistance to antiretroviral agents.
评估旨在减少艾滋病毒感染垂直传播的预防措施的效果，并评估人口统计学、免疫学和病毒学因素对确定艾滋病毒传播给胎儿和新生儿风险的预测价值。
本回顾性研究纳入了53名艾滋病毒阳性女性的56次妊娠。这些女性在过去15年中一直在布拉格大学医院纳布罗夫采传染病科艾滋病中心接受治疗。定期对所有受试者进行细胞免疫测试和艾滋病毒RNA病毒载量检测。根据我们目前的知识和患者的依从性，我们采取了预防措施，包括给予抗逆转录病毒药物、剖宫产和避免母乳喂养。这些妊娠共分娩58名儿童，并进行了重复血液检测以检测艾滋病毒RNA的存在与否。
56次妊娠共分娩58名婴儿，其中3名（5.17%）感染了艾滋病毒。两名母亲在分娩前数小时被诊断为艾滋病毒阳性；另一名女性早期被诊断出感染，但治疗失败是由于她依从性不足。此外，两名女性出现胎膜早破。其中一名还患有未经治疗的梅毒。其他55名儿童未感染。然而，其中6名儿童未完全遵循预防措施，主要是因为患者忽视了这些措施。
该研究充分证实了预防措施的高效性，这些措施大幅降低了艾滋病毒感染垂直传播的风险。依法对所有孕妇进行常规血液检测是必要的。预防失败在大多数情况下是由于治疗依从性不足。然而，我们不能排除对抗逆转录病毒药物可能产生的耐药性。
