Gao Y, Wang X Y, Gao Q, Huang D X, Wang Q, Wang Y, Zheng H Q, Li X W, Fu C Y, Zhang Z Q, Wang A L
National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing 100081, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2024 Jun 10;45(6):833-838. doi: 10.3760/cma.j.cn112338-20240105-00005.
To understand the loss to follow-up of children born to pregnant women with HIV infection (HIV-exposed children) and analyze its influencing factors in China in 2019. The data were collected from the follow-up records of pregnant women with HIV infection and their children reported by the national "Management Information System for the Prevention of HIV, syphilis and Hepatitis B Mother-to-Child Transmission" in 2019. HIV-exposed children were defined as those who were not followed up after birth or who were not followed up at 18 months of age and who were not followed up at 21 months of age. The univariate and multivariate influencing factors of loss to follow-up of children born to HIV-infected pregnant women were analyzed by test and logistic regression model. SPSS 25.0 software was used for statistical analysis. The number of HIV-infected pregnant women was 5 039, the number of live-born children was 5 035, the number of loss to follow-up children within 18 months of age was 283, and the loss to follow-up rate children was 5.62%(283/5 035). The results of multivariate logistic regression analysis showed that the rate of loss to follow-up of exposed children born to pregnant women who worked as farmers (animal husbandry and fishery) (a=0.34, 95%: 0.22-0.53), unmarried (a=0.47, 95%: 0.24-0.93), first marriage (a=0.38, 95%: 0.22-0.67), remarriage (a=0.36, 95%: 0.20-0.67) and cohabiting (a=0.47, 95%: 0.23-0.97), and knew they had HIV infection before this pregnancy (a=0.53, 95%: 0.40-0.70) was lower. Han nationality (a=1.52, 95%: 1.09-2.13), primary school (a=2.06, 95%: 1.10-3.89) and junior middle school (a=1.81, 95%: 1.03-3.17) educational level, non-use of antiviral drugs (a=6.21, 95%: 4.32-8.93) and delivery in township (street) level midwifery institutions (a=5.72, 95%: 1.61-20.27) had higher rates of loss to follow-up among infants born to HIV-infected pregnant women. HIV-exposed children still have a specific rate of loss to follow-up in China in 2019. In order to further reduce the rate of loss to follow-up, it is of great significance to improve the detection rate of HIV before pregnancy and the rate of antiviral drugs used in pregnant women with HIV infection, which is of great significance for the effective implementation of comprehensive intervention measures of prevention of mother-to-child transmission of HIV.
了解2019年中国艾滋病病毒感染孕妇所生儿童（受艾滋病病毒暴露儿童）的失访情况并分析其影响因素。数据来源于全国“预防艾滋病、梅毒和乙肝母婴传播管理信息系统”2019年报告的艾滋病病毒感染孕妇及其儿童的随访记录。受艾滋病病毒暴露儿童定义为出生后未进行随访、18月龄未进行随访或21月龄未进行随访的儿童。采用检验和logistic回归模型分析艾滋病病毒感染孕妇所生儿童失访的单因素和多因素影响因素。使用SPSS 25.0软件进行统计分析。艾滋病病毒感染孕妇5039例，活产儿童5035例，18月龄内失访儿童283例，失访率为5.62%（283/5035）。多因素logistic回归分析结果显示，从事农民（畜牧、渔业）工作的孕妇所生暴露儿童（α=0.34，95%：0.22 - 0.53）、未婚（α=0.47，95%：0.24 - 0.93）、初婚（α=0.38，95%：0.22 - 0.67）、再婚（α=0.36，95%：0.20 - 0.67）及同居（α=0.47，95%：0.23 - 0.97）且本次妊娠前知晓自己感染艾滋病病毒（α=0.53，95%：0.40 - 0.70）的失访率较低。汉族（α=1.52，95%：1.09 - 2.13）、小学（α=2.06，95%：1.10 - 3.89）及初中（α=1.81，95%：1.03 - 3.17）文化程度、未使用抗病毒药物（α=6.21，95%：4.32 - 8.93）及在乡镇（街道）级助产机构分娩（α=5.72，95%：1.61 - 20.27）的艾滋病病毒感染孕妇所生婴儿失访率较高。2019年中国受艾滋病病毒暴露儿童仍有一定失访率。为进一步降低失访率，提高妊娠前艾滋病病毒检测率及艾滋病病毒感染孕妇抗病毒药物使用率对有效实施艾滋病母婴传播综合干预措施具有重要意义。
