赞比亚产前队列中 HIV 血清状态、病毒载量和中孕期宫颈长度。
HIV serostatus, viral load, and midtrimester cervical length in a Zambian prenatal cohort.
机构信息
Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
University of North Carolina Global Projects Zambia, Lusaka, Zambia.
出版信息
Int J Gynaecol Obstet. 2019 Aug;146(2):206-211. doi: 10.1002/ijgo.12823. Epub 2019 Apr 29.
OBJECTIVE
To evaluate whether maternal HIV serostatus and plasma viral load (VL) are associated with midtrimester cervical length (CL).
METHODS
The Zambian Preterm Birth Prevention Study (ZAPPS) is an ongoing prospective cohort that began enrolling in Lusaka in August 2015. Pregnant women undergo ultrasound to determine gestational age and return for CL measurement at 16-28 weeks. We evaluated crude and adjusted associations between dichotomous indicators and short cervix (≤2.5 cm) via logistic regression, and between VL and CL as a continuous variable via linear regression.
RESULTS
This analysis includes 1171 women enrolled between August 2015 and September 2017. Of 294 (25.1%) HIV-positive women, 275 (93.5%) had viral load performed close to CL measurement; of these, 148 (53.8%) had undetectable virus. Median CL was 3.6 cm (IQR 3.5-4.0) and was similar in HIV-infected (3.7 cm, IQR 3.5-4.0) versus uninfected (3.6 cm, IQR 3.5-4.0) participants (P=0.273). The odds of short CL were similar by HIV serostatus (OR 0.64; P=0.298) and detectable VL among those infected (OR 2.37, P=0.323). We observed no association between log VL and CL via linear regression (-0.12 cm; P=0.732).
CONCLUSION
We found no evidence of association between HIV infection and short CL.
目的
评估母体 HIV 感染状况和血浆病毒载量（VL）与妊娠中期宫颈长度（CL）的关系。
方法
赞比亚早产预防研究（ZAPPS）是一项正在进行的前瞻性队列研究，于 2015 年 8 月在卢萨卡开始招募研究对象。孕妇接受超声检查以确定孕周，并在 16-28 周时返回测量 CL。我们通过逻辑回归评估二分类指标与短颈（≤2.5cm）之间的粗关联和调整关联，并通过线性回归评估 VL 与 CL 之间的连续变量关联。
结果
这项分析包括 2015 年 8 月至 2017 年 9 月期间招募的 1171 名妇女。在 294 名（25.1%）HIV 阳性妇女中，有 275 名（93.5%）在接近 CL 测量时进行了病毒载量检测；其中，有 148 名（53.8%）病毒载量不可检测。CL 的中位数为 3.6cm（IQR 3.5-4.0），在 HIV 感染者（3.7cm，IQR 3.5-4.0）和未感染者（3.6cm，IQR 3.5-4.0）之间相似（P=0.273）。在感染人群中，CL 较短的可能性与 HIV 血清状态（OR 0.64；P=0.298）和可检测到的 VL（OR 2.37，P=0.323）无关。我们通过线性回归发现 logVL 与 CL 之间无关联（-0.12cm；P=0.732）。
结论
我们没有发现 HIV 感染与短颈之间存在关联的证据。
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