Tsertsvadze Tengiz, Kakabadze Tea, Shermadini Ketevan, Abutidze Akaki, Karchava Marika, Chkhartishvili Nikoloz, Badridze Nino, Bokhua Zaza, Asatiani Tengiz
Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia.
Cent Eur J Public Health. 2008 Sep;16(3):128-33. doi: 10.21101/cejph.a3484.
The objective of this paper is to review experience in prevention of mother-to-child transmission (PMTCT) of HIV in Georgia.
PMTCT is one of the strategic priorities in Georgia. The first case of HIV infection in pregnant women was reported in 1999. Starting 2005 the National Programme on PMTCT became operational.
One hundred sixteen HIV voluntary counselling and testing (VCT) centers operate throughout the country at antenatal clinics. According to the National PMTCT protocol, all first time attending pregnant women are offered Voluntary Counselling and Testing (VCT). Testing on HIV/AIDS is based on identification of HIV antibodies by screening method and all positive results are referred to the Infectious Diseases, AIDS and Clinical Immunology Research Center (IDACIRC) for the further investigation (confirmation by Western Blot assay) and further management. Data collection was made retrospectively, using information from IDACIRC National HIV/AIDS Data Base, VRF for the period 1999-2007.
Prevalence of HIV among pregnant women availing VCT services in 2006 was 0.03%. As of December, 2007 total 69 pregnancies of 64 women were registered at the IDACIRC. Fifty eight women (90.6%) acquired infection through heterosexual contact. None of the HIV positive women reported intravenous injection of illicit drugs. The majority of the HIV infected pregnant women had one sexual partner (90.6%). Of children delivered by 51 positive partners 41(80%) were infected through injecting drugs intravenously and 10 (20%) persons through heterosexual contacts. Throughout the period 1999-2007 14 pregnant women received PMTCT services only partially. In 2 cases children were HIV-infected. In 12 pregnancies women received AZT in about the 28th week of pregnancy. No case of HIV transmission to child was recorded in this group. In 32 cases pregnant women received full prophylaxis therapy and all children were negative for HIV infection. Among 6 pregnant women admitted at IDACIRC later than the 28th week of pregnancy only 1 child was infected. As of December 2007, 5 women are still pregnant. Three of them receive antiretroviral drugs (ARV) prophylaxis with AZT+3TC+SQV/r. Two women are under 28 weeks of gestational age.
Over the last several years the national response to AIDS in Georgia achieved significant progress. The provision of comprehensive packages of PMTCT services in Georgia has been shown to minimize the risk of vertical transmission. As described above none of the women completing full course of ARV prophylaxis, combined with appropriate infant feeding, transmitted HIV to their children. PMTCT programmes are indisputably the main entry point not only for HIV related care and treatment for women, but also for other comprehensive care and prevention.
本文旨在回顾格鲁吉亚预防艾滋病毒母婴传播（PMTCT）的经验。
PMTCT是格鲁吉亚的战略重点之一。1999年报告了首例孕妇感染艾滋病毒的病例。从2005年起，国家PMTCT计划开始实施。
全国有116个艾滋病毒自愿咨询检测（VCT）中心在产前诊所开展工作。根据国家PMTCT方案，所有首次就诊的孕妇都可获得自愿咨询检测服务。艾滋病毒/艾滋病检测基于通过筛查方法识别艾滋病毒抗体，所有阳性结果都被转介到传染病、艾滋病和临床免疫学研究中心（IDACIRC）进行进一步调查（通过免疫印迹法确认）和进一步管理。数据收集采用回顾性方法，利用IDACIRC国家艾滋病毒/艾滋病数据库、1999 - 2007年期间的VRF信息。
2006年接受VCT服务的孕妇中艾滋病毒感染率为0.03%。截至2007年12月，IDACIRC共登记了64名妇女的69次怀孕情况。58名妇女（90.6%）通过异性接触感染。没有艾滋病毒阳性妇女报告静脉注射非法药物。大多数感染艾滋病毒的孕妇有一个性伴侣（90.6%）。在51名阳性伴侣所生的孩子中，41名（80%）通过静脉注射毒品感染，10名（20%）通过异性接触感染。在1999 - 2007年期间，14名孕妇仅部分接受了PMTCT服务。其中2例儿童感染了艾滋病毒。12例怀孕妇女在怀孕约28周时接受了齐多夫定治疗。该组未记录到艾滋病毒母婴传播病例。32例怀孕妇女接受了全程预防治疗，所有儿童艾滋病毒感染检测均为阴性。在IDACIRC登记的6例怀孕超过28周的妇女中，只有1例儿童感染。截至2007年12月，5名妇女仍在怀孕。其中3名接受了齐多夫定+拉米夫定+茚地那韦/利托那韦的抗逆转录病毒药物（ARV）预防治疗。2名妇女孕周小于28周。
在过去几年中，格鲁吉亚对艾滋病的国家应对取得了显著进展。格鲁吉亚提供的全面PMTCT服务套餐已被证明可将垂直传播风险降至最低。如上所述，没有一名完成ARV预防全程治疗并采用适当婴儿喂养方式的妇女将艾滋病毒传播给其子女。PMTCT项目无疑不仅是妇女艾滋病毒相关护理和治疗的主要切入点，也是其他综合护理和预防的主要切入点。
