University Medical Centre Mannheim, Pediatric Clinic, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
Eur J Med Res. 2009 Nov 3;14(11):461-79. doi: 10.1186/2047-783x-14-11-461.
In Germany during the last years about 200-250 HIV1-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 HIV1-infection was known during pregnancy, since 1995 the rate of vertical transmission of HIV1 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 HIV1-infected mother. To keep pace with new results in research, approval of new anti-retroviral drugs and changes in the general treatment recommendations for HIV1-infected adults, in 1998, 2001, 2003 and 2005 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 fifth update became necessary in 2008. The updating process was started in January 2008 and was terminated in September 2008. The guidelines provide new recommendations on the indication and the starting point for HIV-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 HIV1-transmission should be further maintained.
在过去的几年中，德国每年约有 200-250 名 HIV1 感染的孕妇分娩，这个数字目前正在增加。为了在孕期尽早确定 HIV 状态，德国和奥地利建议所有孕妇自愿进行 HIV 检测，这是产前护理的一部分。在那些已知孕妇感染 HIV1 的情况下，自 1995 年以来，HIV1 的垂直传播率已降低至 1-2%。- 这种低传播率是通过对孕妇进行抗逆转录病毒治疗、在分娩前计划剖腹产、对新生儿进行抗逆转录病毒暴露后预防以及感染 HIV1 的母亲避免母乳喂养来实现的。为了跟上研究的新成果，批准新的抗逆转录病毒药物并改变针对 HIV1 感染成人的一般治疗建议，1998 年、2001 年、2003 年和 2005 年举行了一次跨学科共识会议。妇科医生、传染病专家、儿科医生、药理学家、病毒学家和德国艾滋病援助组织（非政府组织）的成员参加了这次会议，以更新预防策略。2008 年又进行了第五次更新。更新过程于 2008 年 1 月开始，并于 2008 年 9 月结束。这些指南提供了关于无并发症妊娠中 HIV 治疗的适应证和起始点的新建议、这些妊娠中首选的药物和药物组合以及抗逆转录病毒药物不良反应的最新信息。还再次规定了不同情况下和不同风险组合的程序。- 通过德国和奥地利目前的这些指南，应进一步维持 HIV1 垂直传播的低率。
