Buchholz Bernd, Beichert M, Marcus U, Grubert T, Gingelmaier A, Haberl A, Schmied B, Brockmeyer N
HIV-Ambulanz der Universitätskinderklinik Mannheim, Theodor-Kutzer-Ufer 1-3, 68135 Mannheim, Germany.
Eur J Med Res. 2006 Sep 29;11(9):359-76.
In Germany during the last years about 200-250 HIV infected pregnant women delivered a baby each year, a number that is currently increasing. To determine the HIV-status early in pregnancy voluntary HIV-testing of all pregnant women is recommended in Germany and Austria as part of prenatal care. In those cases, where HIV infection was known during pregnancy, since 1995 the rate of vertical transmission of HIV was reduced to 1-2%. - This low transmission rate has been achieved by the combination of anti-retroviral therapy of pregnant women, caesarean section scheduled before onset of labour, anti-retroviral post exposition prophylaxis in the newborn and refraining from breast-feeding by the HIV infected mother. To keep pace with new results in research, approval of new anti-retroviral drugs and changes in the general treatment recommendations for HIV infected adults, in 1998, 2001 and 2003 an interdisciplinary consensus meeting was held. Gynaecologists, infectious disease specialists, paediatricians, pharmacologists, virologists and members of the German AIDS Hilfe (NGO) were participating in this conference to update the prevention strategies. A third update became necessary in 2005. The updating process was started in January 2005 and was terminated in September 2005. The guidelines provide new recommendations on the indication and the starting point for therapy in pregnancies without complications, drugs and drug combinations to be used preferably in these pregnancies and updated information on adverse effects of anti-retroviral drugs. Also the procedures for different scenarios and risk constellations in pregnancy have been specified again. With these current guidelines in Germany and Austria the low rate of vertical HIV-transmission should be further maintained.
在德国，过去几年中每年约有200 - 250名感染艾滋病毒的孕妇分娩，这一数字目前正在上升。为了在妊娠早期确定艾滋病毒感染状况，德国和奥地利建议对所有孕妇进行自愿艾滋病毒检测，作为产前护理的一部分。在那些孕期已知感染艾滋病毒的病例中，自1995年以来，艾滋病毒的垂直传播率已降至1% - 2%。——这一低传播率是通过孕妇抗逆转录病毒疗法、分娩发动前安排剖宫产、新生儿暴露后抗逆转录病毒预防以及艾滋病毒感染母亲不进行母乳喂养相结合而实现的。为了跟上研究的新成果、新抗逆转录病毒药物的批准以及艾滋病毒感染成人一般治疗建议的变化，在1998年、2001年和2003年召开了跨学科共识会议。妇科医生、传染病专家、儿科医生、药理学家、病毒学家以及德国艾滋病援助组织（非政府组织）的成员参加了此次会议，以更新预防策略。2005年有必要进行第三次更新。更新过程于2005年1月开始，2005年9月结束。这些指南提供了关于无并发症妊娠治疗的指征和起始点、这些妊娠中优选使用的药物和药物组合的新建议，以及抗逆转录病毒药物不良反应的最新信息。此外，还再次明确了妊娠不同情况和风险组合的处理程序。有了德国和奥地利目前的这些指南，艾滋病毒的低垂直传播率应能进一步保持。
