HIV 暴露婴儿的母婴传播 HIV 阳性率、趋势及相关危险因素。
Positivity rate, trend and associated risk factors of mother-to-child transmission of HIV among HIV-exposed infants.
机构信息
HIV/AIDS Research Team, TB and HIV/AIDS Research Directorate, Ethiopian Public Health Institute, PO Box 1242, Addis Ababa, Ethiopia.
Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, PO Box 1176, Addis Ababa, Ethiopia.
出版信息
BMC Pediatr. 2023 Jun 6;23(1):283. doi: 10.1186/s12887-023-04074-2.
BACKGROUND
Mother-To-Child-Transmission (MTCT) of Human Immunodeficiency Virus (HIV) occurs during pregnancy, delivery and breastfeeding, and cause infection among several new-borns. However, there is limited recent evidence on the burden of MTCT of HIV in Ethiopia from a large-scale data. Thus, this study aimed to determine the positivity rate, trend and associated risk factors of MTCT among HIV-exposed infants.
METHODOLOGY
A cross-sectional study was conducted among 5,679 infants whose specimen referred to Ethiopian Public Health Institute HIV referral laboratory for Early Infant Diagnosis (EID) from January 01, 2016, to December 31, 2020. Data were extracted from the national EID database. Frequencies and percentages were used to summarize the data on characteristics of infants. Logistic regression analysis was employed to identify factors associated with positivity rate of MTCT of HIV. Level of significance was set at 5%.
RESULTS
The mean age of the infants was 12.6 (± 14.6) weeks with an age range of 4 to 72 weeks. Half of the infants (51.4%) were female. The positivity rate of MTCT decreased from 2.9% in 2016 to 0.9% in 2020 with five-year average positivity rate of 2.6%. HIV test after six weeks (Adjusted odds ratio (AOR) = 2.7; 95% confidence interval (CI): (1.8-4.0,)); p < 0.001), absence of prevention of mother-to-child-transmission (PMTCT) service (AOR = 4.6; 95% CI: (2.9-7.4)); p = 0.001), nevirapine prophylaxis not received (AOR = 2.0; 95% CI: (1.3-3.2)); p < 0.001), and unknown ART status of the mother at delivery (AOR = 11; 95% CI: (5.5-22.1)); p < 0.001) were significantly associated with MTCT of HIV.
CONCLUSION
The positivity rate of MTCT of HIV was showing declining tendency gradually in the study period. Strengthening PMTCT service, early HIV screening and starting ART for pregnant women, and early infant diagnosis are required to reduce the burden of HIV infection among infants exposed to HIV.
背景
人类免疫缺陷病毒（HIV）的母婴传播（MTCT）发生在妊娠、分娩和母乳喂养期间，导致许多新生儿感染。然而，由于缺乏大规模数据，最近埃塞俄比亚关于 HIV 母婴传播负担的证据有限。因此，本研究旨在确定 HIV 暴露婴儿中 MTCT 的阳性率、趋势和相关危险因素。
方法
这是一项横断面研究，对象为 2016 年 1 月 1 日至 2020 年 12 月 31 日期间，将标本送往埃塞俄比亚公共卫生研究所 HIV 转介实验室进行早期婴儿诊断（EID）的 5679 名婴儿。数据从国家 EID 数据库中提取。使用频率和百分比总结婴儿特征的数据。采用逻辑回归分析确定与 HIV 母婴传播阳性率相关的因素。显著性水平设为 5%。
结果
婴儿的平均年龄为 12.6（±14.6）周，年龄范围为 4 周至 72 周。一半的婴儿（51.4%）为女性。MTCT 的阳性率从 2016 年的 2.9%下降到 2020 年的 0.9%，五年平均阳性率为 2.6%。六周后进行 HIV 检测（调整后的优势比（AOR）=2.7；95%置信区间（CI）：（1.8-4.0）；p<0.001）、未接受预防母婴传播（PMTCT）服务（AOR=4.6；95%CI：（2.9-7.4）；p=0.001）、未接受奈韦拉平预防（AOR=2.0；95%CI：（1.3-3.2）；p<0.001）和母亲分娩时未知抗逆转录病毒治疗（ART）状态（AOR=11；95%CI：（5.5-22.1）；p<0.001）与 MTCT 的 HIV 显著相关。
结论
在研究期间，HIV 母婴传播的阳性率呈逐渐下降趋势。需要加强 PMTCT 服务、早期 HIV 筛查和为孕妇启动 ART 以及早期婴儿诊断，以降低 HIV 暴露婴儿的 HIV 感染负担。
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