简短报告：“B+方案”对马拉维利隆圭婴儿预防母婴传播流程的影响
Brief Report: Impact of Option B+ on the Infant PMTCT Cascade in Lilongwe, Malawi.
作者信息
Kim Maria H, Ahmed Saeed, Hosseinipour Mina C, Yu Xiaoying, Nguyen Chi, Chimbwandira Frank, Paul Mary E, Kazembe Peter N, Abrams Elaine J
机构信息
*Baylor College of Medicine International Pediatric AIDS Initiative at Texas Children's Hospital, Houston, TX; †Baylor College of Medicine-Abbott Fund Children's Clinical Center of Excellence, Lilongwe, Malawi; ‡UNC Project, Lilongwe, Malawi; §University of North Carolina School of Medicine, Chapel Hill, NC; ‖Department of Pediatrics, Epidemiology Center, Baylor College of Medicine, Houston, TX; ¶Department of HIV and AIDS, Ministry of Health, Lilongwe, Malawi; #ICAP-Columbia University, Mailman School of Public Health, New York, NY; and **College of Physicians and Surgeons, Columbia University, New York, NY.
出版信息
J Acquir Immune Defic Syndr. 2015 Sep 1;70(1):99-103. doi: 10.1097/QAI.0000000000000692.
This observational study compared uptake of infant prevention of mother-to-child transmission of HIV services pre/post implementation of Option B+ in Lilongwe, Malawi. There were 845 (pre) and 998 (post) births. Post-B+, infants had longer median predelivery maternal antiretroviral therapy {62 days [interquartile range (IQR): 38-94] pre-B+ vs. 95 days [IQR: 61-131] post-B+; P < 0.0001} and improved polymerase chain reaction testing (82.0% vs. 86.5%; P = 0.01) at younger median age [7.6 weeks (IQR: 6.6-10.9) vs. 6.9 (IQR: 6.4-8.1); P < 0.0001]. Proportion testing polymerase chain reaction positive decreased (4.6% vs. 2.6%; P = 0.03). Proportion of HIV-infected infants starting antiretroviral therapy (75% vs. 77.3%) and age at initiation [19.7 weeks (IQR: 15.4-31.1) vs. 16 (IQR: 13.3-17.9)] remained unchanged. These findings suggest modest improvements in infant care with Option B+.
这项观察性研究比较了在马拉维利隆圭实施B+方案前后婴儿预防母婴传播艾滋病毒服务的接受情况。产前有845例分娩（实施前），产后有998例分娩。实施B+方案后，婴儿产前接受抗逆转录病毒治疗的中位时间更长{实施B+方案前为62天[四分位间距（IQR）：38 - 94]，实施后为95天[IQR：61 - 131]；P < 0.0001}，且在更小的中位年龄时聚合酶链反应检测情况有所改善（82.0%对86.5%；P = 0.01）[7.6周（IQR：6.6 - 10.9）对6.9周（IQR：6.4 - 8.1）；P < 0.0001]。聚合酶链反应检测呈阳性的比例下降（4.6%对2.6%；P = 0.03）。开始接受抗逆转录病毒治疗的艾滋病毒感染婴儿比例（75%对77.3%）及其开始治疗的年龄[19.7周（IQR：15.4 - 31.1）对16周（IQR：13.3 - 17.9）]保持不变。这些发现表明B+方案在婴儿护理方面有适度改善。
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