Kumar Pradeep, Das Chinmoyee, Das Udayabhanu, Kumar Arvind, Priyam Nidhi, Ranjan Varsha, Sahu Damodar, Rai Sanjay K, Godbole Sheela V, Arumugam Elangovan, Pvm Lakshmi, Dutta Shanta, Devi H Sanayaima, Pandey Arvind, Reddy Dandu Chandra Sekhar, Mehendale Sanjay, Rajan Shobini
National AIDS Control Organization, Ministry of Health and Family Welfare, New Delhi, India.
Indian Council of Medical Research, National Institute of Medical Statistics, New Delhi, India.
PLOS Glob Public Health. 2023 Aug 9;3(8):e0002270. doi: 10.1371/journal.pgph.0002270. eCollection 2023.
The government of India has adopted the elimination of vertical transmission of HIV as one of the five high-level goals under phase V of the National AIDS and STD Control Programme (NACP). In this paper, we present the data from HIV estimations 2021 for India and select States detailing the progress as well as the attributable causes for vertical transmissions. The NACP spearheads work on mathematical modelling to estimate HIV burden based on the periodically conducted sentinel surveillance for guiding program implementation and policymaking. Using the results of the latest round of HIV Estimations in 2021, we analysed the mother-to-child transmission (MTCT) during the perinatal and postnatal (breastfeeding) period. In 2021, overall, around 5,000 [3,000-7,800] vertical transmissions were estimated nationally with 58% being perinatal infections and remaining during breastfeeding. MTCT at 6 weeks was around 12.95% [9.45-16.02] with the final transmission rate at 24.25% [18.50-29.50]. Overall, 57% of vertical transmissions were among HIV-positive mothers who did not receive ART during pregnancy or breastfeeding, 19% among mothers who dropped off ART during pregnancy or delivery, and 18% among mothers who were infected during pregnancy or breastfeeding. There were significant variations between States. Depending upon the States, the programme needs to focus on the intervention domains of timely engagement in antenatal care-HIV testing-ART initiation as well as programme retention and adherence support. Equally important would be strengthening the strategic information to generate related evidence for inputting India and State-specific parameters improving the MTCT-related modelled estimates.
印度政府已将消除艾滋病毒的垂直传播作为国家艾滋病和性传播疾病控制计划（NACP）第五阶段的五个高级目标之一。在本文中，我们展示了2021年印度及部分邦的艾滋病毒估计数据，详细说明了垂直传播的进展情况以及相关成因。NACP率先开展数学建模工作，根据定期进行的哨点监测来估计艾滋病毒负担，以指导项目实施和政策制定。利用2021年最新一轮艾滋病毒估计结果，我们分析了围产期和产后（母乳喂养）期间的母婴传播（MTCT）情况。2021年，全国范围内估计约有5000例[3000 - 7800例]垂直传播，其中58%为围产期感染，其余为母乳喂养期间感染。6周时的母婴传播率约为12.95%[9.45 - 16.02]，最终传播率为24.25%[18.50 - 29.50]。总体而言，57%的垂直传播发生在孕期或哺乳期未接受抗逆转录病毒治疗（ART）的艾滋病毒阳性母亲中，19%发生在孕期或分娩期间中断ART治疗的母亲中，18%发生在孕期或哺乳期感染的母亲中。各邦之间存在显著差异。根据不同邦的情况，该项目需要关注及时参与产前护理 - 艾滋病毒检测 - 启动ART以及项目维持和依从性支持等干预领域。同样重要的是加强战略信息，以生成相关证据，输入印度及邦的特定参数，改进与母婴传播相关的模型估计。
