围生期 HIV 及其预防：迈向无 HIV 世代的进展。

Perinatal HIV and its prevention: progress toward an HIV-free generation.

机构信息

Department of Pathology, The Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21224, USA.

出版信息

Clin Perinatol. 2010 Dec;37(4):699-719, vii. doi: 10.1016/j.clp.2010.09.002.

DOI:10.1016/j.clp.2010.09.002

PMID:21078445

Abstract

This article reviews the epidemiology of perinatal (HIV)-1 in the United States in the past 2 decades and the international HIV epidemic among pregnant women and their infants. Since the peak of 1700 reported cases of pediatric AIDS in 1992, there has been dramatic progress in decreasing perinatal HIV transmission in the United States with fewer than 50 new cases of AIDS annually (>96% reduction) and fewer than 300 annual perinatal HIV transmissions in 2005. This success has been due to use of combination antiretrovirals given to mothers during pregnancy and labor/delivery, obstetric interventions that reduce the risk of transmission, provision of zidovudine (ZDV) prophylaxis for 6 weeks to HIV-exposed newborns and use of formula. Internationally, the burden of mother-to-child HIV transmission remains heavy with 2.1 million children less than 15 years of age estimated to be living with HIV and 430,000 new HIV infections in infants occurring each year, with most cases occurring in Africa. Current international efforts are directed at scaling up successful prevention of mother-to-child transmission interventions and new research directed at making breastfeeding safer using antiretroviral prophylaxis to either mothers or their infants.

摘要

本文回顾了过去 20 年美国围产期（HIV）-1 的流行病学以及孕妇及其婴儿的国际 HIV 流行情况。自 1992 年报告的儿童艾滋病病例达到 1700 例的高峰以来，美国围产期 HIV 传播的减少取得了显著进展，每年新发病例不到 50 例（减少了 96%以上），2005 年每年的围产期 HIV 传播病例不到 300 例。这一成功得益于在孕妇怀孕期间和分娩期间使用联合抗逆转录病毒药物、减少传播风险的产科干预措施、为 HIV 暴露的新生儿提供 6 周齐多夫定（ZDV）预防以及使用配方奶。在国际上，母婴 HIV 传播的负担仍然很重，估计有 210 万 15 岁以下的儿童携带 HIV，每年有 43 万新生儿感染 HIV，大多数病例发生在非洲。目前国际上的努力旨在扩大成功的母婴传播预防干预措施，并开展新的研究，通过对母亲或婴儿使用抗逆转录病毒预防来使母乳喂养更安全。