Department of Virology, National Health Laboratory Service and Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
J Acquir Immune Defic Syndr. 2013 Jul 1;63(3):410-5. doi: 10.1097/QAI.0b013e3182926931.
To describe a trend in perinatal HIV transmission associated with the implementation of rapidly changing prevention of mother to child transmission (PMTCT) interventions from 2004 to 2012.
Retrospective analysis of infant HIV polymerase chain reaction results of infants from 2004 to 2012 archived from a Laboratory Information System.
KwaZulu-Natal, South Africa.
HIV infection in infants aged 4-8 weeks.
The proportion of 4- to 8-week-old infants who tested HIV polymerase chain reaction positive decreased significantly (P < 0.0001) from 27.5% in 2004 to 2.9% in 2012. The reduction rates in perinatal HIV infections in 4- to 8-week-old HIV-exposed infants decreased significantly (P < 0.0001) by 48.7% following single-dose nevirapine (sdNVP) (2005 to April 2008), 68.4% with zidovudine from 28 weeks and sdNVP together with triple antiretroviral therapy for women with CD4 cell count < 200 cells/mm³ (May 2008-April 2010), and 89.5% with zidovudine from 14 weeks, sdNVP, and triple antiretroviral therapy for women with CD4⁺ cell count < 350 cells/mm³ (May 2010-December 2012).
We show an almost 10-fold reduction in mother to child transmission from 2004 to 2012 in infants aged 4-8 weeks during a rapid implementation of more complex and robust PMTCT interventions. The significant reductions in mother to child transmission in the South African PMTCT program are encouraging for a middle-income country with the second highest antenatal HIV prevalence in the world.
描述 2004 年至 2012 年期间，由于不断变化的预防母婴传播（PMTCT）干预措施的实施，围产期 HIV 传播的趋势。
对 2004 年至 2012 年期间从实验室信息系统中存档的婴儿 HIV 聚合酶链反应结果进行回顾性分析。
南非夸祖鲁-纳塔尔省。
4-8 周龄婴儿 HIV 感染情况。
4-8 周龄婴儿 HIV 聚合酶链反应阳性的比例从 2004 年的 27.5%显著下降（P < 0.0001）至 2012 年的 2.9%。4-8 周龄 HIV 暴露婴儿围产期 HIV 感染的降低率也显著下降（P < 0.0001）：单剂量奈韦拉平（sdNVP）（2005 年至 2008 年 4 月）下降 48.7%，28 周开始联合 ZDV 和 sdNVP 以及对 CD4 细胞计数 < 200 个/立方毫米的妇女进行三联抗逆转录病毒治疗（2008 年 5 月至 2010 年 4 月）下降 68.4%，14 周开始联合 ZDV、sdNVP 和三联抗逆转录病毒治疗以及对 CD4⁺细胞计数 < 350 个/立方毫米的妇女（2010 年 5 月至 2012 年 12 月）下降 89.5%。
我们发现，在更复杂和更有效的 PMTCT 干预措施的快速实施期间，4-8 周龄婴儿的母婴传播率从 2004 年到 2012 年几乎降低了 10 倍。南非 PMTCT 项目中母婴传播率的显著降低，对于这个世界上第二大产前 HIV 流行率的中等收入国家来说是令人鼓舞的。
