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广西灵山县接受抗逆转录病毒疗法预防母婴传播的人类免疫缺陷病毒阳性母亲对18个月大儿童生长发育的影响

[Effects of Human Immunodeficiency Virus-positive Mothers Receiving Antiretroviral Therapy to Prevent Mother-to-child Transmission on the Growth and Development of 18-month-old Children in Lingshan County of Guangxi].

作者信息

Ge Xian-Min, Lin Mei, Chen Jin-Mei, Zhu Jin-Hui, Lan Guang-Hua, Yan Yu, Chen Huan-Huan, Luo Liu-Hong, Li Shan-Shan, Li Bin, Huang Guang-Hua, Li Jia-Wei, Deng Yue-Qin, Wen Ping-Jing, Huang Yu-Man, Zhu Qiu-Ying, Meng Qin, Liu Shuai-Feng, Wu Xiu-Ling, Huang Jing-Hua, Lu Hua-Xiang

机构信息

Institute of AIDS Prevention and Control,Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention,Nanning 530028,China.

Center for Disease Control and Prevention of Lingshan County,Lingshan,Guangxi 535400,China.

出版信息

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2021 Oct;43(5):743-748. doi: 10.3881/j.issn.1000-503X.14371.

Abstract

Objective To evaluate the effects of antiretroviral therapy(ART)for the prevention of mother-to-child transmission(PMTCT)of acquired immune deficiency syndrome(AIDS)on the growth and development of 18-month-old children born by human immunodeficiency virus(HIV)-positive pregnant women in Lingshan County,Guangxi Zhuang Autonomous Region,and provide scientific evidence for improving the ART medication plan for PMTCT.Methods Lingshan County,ranking the first in the HIV-epidemic counties of Guangxi,was selected as the research site.According to the design of retrospective case-control study,we assigned all the subjects into the case group and the control group:(1)The case group included the HIV-positive pregnant women who had received ART for PMTCT and their HIV-negative infants in Lingshan County from 2010 to 2017.The historical cards and PMTCT data of them were collected from the national PMTCT database.(2)The control group included the healthy pregnant women and their healthy babies born in the Lingshan Maternity and Infant Hospital in 2017,and the children's growth and development data were collected.The stunted growth in children was defined as at least one of the three main indicators of body height,body weight,and head circumference below the normal range.Results The number of HIV-positive mothers and their infants in the case group was 391 and 368,respectively,and 87.21%(341/391)and 95.38%(351/368)of mothers and infants respectively received ART medication.The HIV positive rate,mortality rate,and mother-to-child transmission rate of 18-month-old children were 1.36%(5/368),4.35%(16/368),and 2.01%(5/249),respectively.The incidence of stunted growth of 18-month-old children in the case group and the control group was 42.12%(155/368)and 23.06%(101/438),respectively,with significant difference(=33.520,<0.001).Conclusion After HIV-positive mothers in Lingshan County of Guangxi received ART for PMTCT,the incidence of growth stunting in 18-month-old children increased.

摘要

目的 评估广西壮族自治区灵山县接受抗逆转录病毒治疗(ART)预防母婴传播获得性免疫缺陷综合征(AIDS)对人类免疫缺陷病毒(HIV)阳性孕妇所生18月龄儿童生长发育的影响,为优化预防母婴传播的ART用药方案提供科学依据。方法 选取广西HIV疫情排名第一的灵山县作为研究现场。按照回顾性病例对照研究设计,将所有研究对象分为病例组和对照组:(1)病例组为2010年至2017年在灵山县接受预防母婴传播ART的HIV阳性孕妇及其HIV阴性婴儿,其历史卡片及预防母婴传播数据从国家预防母婴传播数据库收集。(2)对照组为2017年在灵山县妇幼保健院分娩的健康孕妇及其健康婴儿,收集儿童生长发育数据。儿童生长发育迟缓定义为身高、体重、头围三项主要指标中至少一项低于正常范围。结果 病例组HIV阳性母亲及其婴儿分别为391例和368例,母亲和婴儿接受ART治疗的比例分别为87.21%(341/391)和95.38%(351/368)。18月龄儿童HIV阳性率、死亡率、母婴传播率分别为1.36%(5/368)、4.35%(16/368)、2.01%(5/249)。病例组和对照组18月龄儿童生长发育迟缓发生率分别为42.12%(155/368)和23.06%(101/438),差异有统计学意义(=33.520,<0.001)。结论 广西灵山县HIV阳性母亲接受预防母婴传播ART后,18月龄儿童生长发育迟缓发生率升高。

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