Robert Koch-Institut, Berlin, Germany.
Euro Surveill. 2019 Nov;24(48). doi: 10.2807/1560-7917.ES.2019.24.48.1900078.
BackgroundElimination of mother-to-child transmission (MTCT) of HIV by 2020 is a goal of the World Health Organization (WHO) action plan for the European Region. However, data to monitor progress towards MTCT elimination are not readily available in Germany.AimWe aimed to estimate the number of pregnant women with HIV and MTCT rates in Germany.MethodsWe triangulated retrospectively obtained data from: (i) healthcare reimbursement for HIV screening tests, (ii) a statutory health insurance subsample of prevalent and incident HIV diagnoses among pregnant women, (iii) a mathematical model of the German HIV epidemic with number, region of origin and risk factors for women of childbearing age, and (iv) the statutory anonymous HIV registry on children infected through HIV MTCT.ResultsThe number of women aged 15-49 years with HIV increased from ca 6,000 in 1993 to ca 11,000 in 2016. Risk of injecting drug use (IDU) declined from 65% in 1993 to 16% in 2016. The annual proportion of women living with HIV giving live birth increased from a mean of 1.9% during 1993 to 1998 to 4.9% in 2011 to 2015. HIV screening rates during pregnancy increased from ca 50% in 2001 to ca 90% in 2016. The HIV MTCT rate dropped from 6.8% in 2001 to 1.1% in 2016.ConclusionsThe population of women living with HIV in Germany shifted from predominantly IDU-associated infections to predominantly sexually acquired infections, while fertility rates more than doubled. MTCT rates dropped, mainly because of improved detection and management of HIV in pregnancy.
消除母婴传播（MTCT）艾滋病毒是世界卫生组织（世卫组织）在欧洲区域行动计划的目标。然而，德国目前还没有用于监测消除 MTCT 进展的数据。
我们旨在估计德国艾滋病毒感染孕妇数量和 MTCT 率。
我们通过以下方式进行三角测量回顾性获取数据：（i）艾滋病毒筛查测试的医疗保健报销，（ii）艾滋病毒感染孕妇现患和新发的法定健康保险抽样，（iii）德国艾滋病毒流行的数学模型，包括育龄妇女的人数、原籍地区和危险因素，以及（iv）关于通过 HIV MTCT 感染的儿童的法定匿名 HIV 登记册。
1993 年年龄在 15-49 岁之间的艾滋病毒感染妇女数量约为 6000 人，到 2016 年增加到约 11000 人。注射吸毒（IDU）的风险从 1993 年的 65%下降到 2016 年的 16%。1993 年至 1998 年期间，每年艾滋病毒感染生育的妇女比例从平均 1.9%增加到 2011 年至 2015 年的 4.9%。怀孕期间艾滋病毒筛查率从 2001 年的约 50%增加到 2016 年的约 90%。艾滋病毒 MTCT 率从 2001 年的 6.8%下降到 2016 年的 1.1%。
德国艾滋病毒感染妇女的人群从主要与 IDU 相关的感染转变为主要与性传播感染，而生育率增加了一倍以上。MTCT 率下降，主要是因为怀孕期间艾滋病毒的检测和管理得到了改善。
