Wong V V
Department of Obstetrics and Gynaecology, Rotunda Hospital, Dublin, Republic of Ireland.
J Obstet Gynaecol. 2011 Nov;31(8):740-2. doi: 10.3109/01443615.2011.599887.
Late access to obstetrics service, viral load of >1,000 copies/ml and short duration antenatal highly active antiretroviral treatment (HAART), are the strongest predictors for mother-to-child transmission (MTCT). Neonatal triple therapy did not seem to reduce MTCT if the above risk factors were present. Intrapartum intravenous zidovudine (i.v. ZDV) of <4 h does not seem to increase the risk of MTCT if the viral load is <1,000 in those receiving HAART. Intrapartum i.v. ZDV >4 h did not seem to reduce the risk of MTCT with the viral load >1,000 in patients having <4 weeks of HAART.
获得产科服务较晚、病毒载量>1000拷贝/毫升以及产前高效抗逆转录病毒治疗(HAART)疗程较短,是母婴传播(MTCT)的最强预测因素。如果存在上述危险因素,新生儿三联疗法似乎并不能降低母婴传播率。对于接受HAART且病毒载量<1000的患者,产时静脉注射齐多夫定(i.v. ZDV)<4小时似乎不会增加母婴传播风险。对于接受HAART少于4周且病毒载量>1000的患者,产时静脉注射齐多夫定>4小时似乎不会降低母婴传播风险。