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一所大学教学医院在预防母婴传播人类免疫缺陷病毒方面的十年经验。

Ten years of experience in the prevention of mother-to-child human immunodeficiency virus transmission in a university teaching hospital.

作者信息

Park Jung-Weon, Yang Tae-Whan, Kim Yun-Kyung, Choi Byung-Min, Kim Hai-Joong, Park Dae-Won

机构信息

Department of Pediatrics, Korea University College of Medicine, Seoul, Korea.

Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.

出版信息

Korean J Pediatr. 2014 Mar;57(3):117-24. doi: 10.3345/kjp.2014.57.3.117. Epub 2014 Mar 31.

Abstract

PURPOSE

Administration of antiretroviral drugs to mothers and infants significantly decreases mother-to-child human immunodeficiency virus (HIV) transmission; cesarean sections and discouraging breastfeeding further decreases this risk. The present study confirmed the HIV status of babies born to mothers infected with HIV and describes the characteristics of babies and mothers who received preventive treatment.

METHODS

This study retrospectively analyzed medical records of nine infants and their mothers positive for HIV who gave birth at Korea University Ansan Hospital, between June 1, 2003, and May 31, 2013. Maternal parameters, including HIV diagnosis date, CD4+ count, and HIV ribonucleic acid (RNA) copy number, were analyzed. Infant growth and development, HIV RNA copy number, and HIV antigen/antibody test results were analyzed.

RESULTS

Eight HIV-positive mothers delivered nine babies; all the infants received antiretroviral therapy. Three (37.5%) and five mothers (62.5%) were administered single- and multidrug therapy, respectively. Intravenous zidovudine was administered to four infants (50%) at birth. Breastfeeding was discouraged for all the infants. All the infants were negative for HIV, although two were lost to follow-up. Third trimester maternal viral copy numbers were less than 1,000 copies/mL with a median CD4+ count of 325/µL (92-729/µL). Among the nine infants, two were preterm (22.2%) and three had low birth weights (33.3%).

CONCLUSION

This study concludes that prophylactic antiretroviral therapy, scheduled cesarean section, and prohibition of breastfeeding considerably decrease mother-to-child HIV transmission. Because the number of infants infected via mother-to-child transmission may be increasing, studies in additional regions using more variables are necessary.

摘要

目的

对母亲和婴儿使用抗逆转录病毒药物可显著降低母婴间人类免疫缺陷病毒(HIV)传播;剖宫产和不鼓励母乳喂养可进一步降低这种风险。本研究确认了感染HIV母亲所生孩子的HIV状况,并描述了接受预防性治疗的婴儿和母亲的特征。

方法

本研究回顾性分析了2003年6月1日至2013年5月31日在韩国大学安山医院分娩的9名HIV阳性婴儿及其母亲的病历。分析了母亲的参数,包括HIV诊断日期、CD4 +细胞计数和HIV核糖核酸(RNA)拷贝数。分析了婴儿的生长发育、HIV RNA拷贝数和HIV抗原/抗体检测结果。

结果

8名HIV阳性母亲分娩了9名婴儿;所有婴儿均接受了抗逆转录病毒治疗。分别有3名(37.5%)和5名母亲(62.5%)接受了单药和多药治疗。4名婴儿(50%)出生时接受了静脉注射齐多夫定。所有婴儿均不鼓励母乳喂养。所有婴儿的HIV检测均为阴性,尽管有2名婴儿失访。孕晚期母亲的病毒拷贝数低于1000拷贝/毫升,CD4 +细胞计数中位数为325/微升(92 - 729/微升)。9名婴儿中,2名早产(22.2%),3名出生体重低(33.3%)。

结论

本研究得出结论,预防性抗逆转录病毒治疗、择期剖宫产和禁止母乳喂养可显著降低母婴间HIV传播。由于母婴传播感染的婴儿数量可能在增加,因此有必要在更多地区使用更多变量进行研究。

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