Department of Mass Health Care, Nantong Municipal Maternal and Child Health Hospital, Nantong, Jiangsu, China.
Department of Biostatistics, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China.
Curr HIV Res. 2020;18(6):458-465. doi: 10.2174/1570162X18666200810134025.
China has implemented a nation-wide policy to control mother-to-child transmission (MTCT) of the human immunodeficiency virus (HIV) since 2011, yet the efficacy of the control policy is less studied. The aim of the present study was to report the data in the prevention of MTCT of HIV in Nantong city, China.
The screening and prevalence of HIV in pregnant women and the efficacy of prophylaxis in Nantong city, China, January 2012 through December 2018, were analyzed.
Among a total population of 410,044 pregnant women, anti-HIV was tested prenatally in 393,658 (96.0%) women and in 16,287 (3.97%) women at delivery. In total, 51 women were confirmed with HIV infection. After the exclusion of repeat pregnancies, the overall prevalence of HIV infection was 1.20/10 000 (48/400,377). The prevalence (6.75/10,000) in women tested at delivery was >5-fold higher than that (1.02/10,000) in prenatally screened women. Of 48 HIV-infected women, 12 terminated their pregnancies and 36 others delivered 36 neonates, of whom 35 were followed up. No HIV infection occurred in 24 children born to mothers with antiretroviral therapy (ART) during pregnancy along with other preventive measures. Among 11 children born to mothers who did not receive ART during pregnancy because of the absence of a prenatal anti-HIV test, none of the 6 children who were delivered by cesarean section and timely administered neonatal antiretroviral prophylaxis was infected, but 2 (40%) of 5 children who were spontaneously delivered and administered delayed antiretroviral prophylaxis were infected.
Prenatal identification of HIV infection and timely administration of all preventive measures can completely block MTCT of HIV. The data indicate that more efforts must be taken to ensure that all pregnant women are tested for anti-HIV during pregnancy. For pregnant women who missed the prenatal screening, a positive result in rapid anti-HIV test at delivery should be sufficient to take preventive measures to prevent MTCT of HIV.
中国自 2011 年以来实施了一项全国性政策，以控制母婴传播（MTCT）的人类免疫缺陷病毒（HIV），但该控制政策的效果研究较少。本研究的目的是报告中国南通市预防 HIV 母婴传播的数据。
分析 2012 年 1 月至 2018 年 12 月期间中国南通市孕妇 HIV 的筛查和流行情况，以及预防效果。
在总共 410044 名孕妇中，有 393658 名（96.0%）孕妇在产前接受了抗 HIV 检测，有 16287 名（3.97%）孕妇在分娩时接受了检测。共有 51 名妇女被确诊感染 HIV。排除重复妊娠后，HIV 感染的总流行率为 1.20/10000（48/400377）。在分娩时接受检测的妇女中，流行率（6.75/10000）是产前筛查妇女（1.02/10000）的 5 倍以上。48 名 HIV 感染妇女中，12 人终止妊娠，36 人分娩 36 名新生儿，其中 35 人接受了随访。在接受抗逆转录病毒治疗（ART）的母亲所生的 24 名儿童中未发生 HIV 感染，这些母亲在怀孕期间接受了其他预防措施。在 11 名未接受 ART 治疗的母亲中，由于未进行产前抗 HIV 检测，有 6 名儿童经剖宫产分娩并及时给予新生儿抗逆转录病毒预防，未发生感染，但 5 名自然分娩且给予延迟抗逆转录病毒预防的儿童中，有 2 名（40%）发生了感染。
产前识别 HIV 感染并及时采取所有预防措施可完全阻断 HIV 的母婴传播。这些数据表明，必须加大努力，确保所有孕妇在怀孕期间接受抗 HIV 检测。对于错过产前筛查的孕妇，分娩时快速抗 HIV 检测阳性应足以采取预防措施，防止 HIV 母婴传播。
