Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital Zurich, Zurich, Switzerland.
Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.
BMJ Open. 2024 Sep 23;14(9):e086543. doi: 10.1136/bmjopen-2024-086543.
Prospective, multicentric observational cohort study in Switzerland investigating measures to prevent mother-to-child transmission in pregnant women with HIV (WWH) and assessing health and development of their exposed children as well as of children with HIV (CWH) in general.
Between January 1986 and December 2022, a total of 1446 mother-child pairs were enrolled. During the same period, the study also registered 187 CWH and 521 HIV-exposed but uninfected children (HEU), for whom detailed maternal information was not available. Consequently, the cohort comprises a total of 2154 children.
During these 37 years, research by the Swiss Mother and Child HIV Cohort Study (MoCHiV) and its international collaborators has strongly influenced the prevention of vertical transmission of HIV (eg, introduction and discontinuation of elective caesarean section, neonatal postexposure prophylaxis and breastfeeding). Contributions have also been made to the management of diagnostics (eg, p24 antigen assay) and the effects of antiretroviral treatment (eg, prematurity, growth) in HEU and CWH.
Most children present within the cohort are now HEU, highlighting the need to investigate other vertically transmitted pathogens such as hepatitis B and C viruses, cytomegalovirus or . In addition, analyses are planned on the longitudinal health status of CWH (eg, resistance and prolonged exposure to antiretroviral therapy), on social aspects including stigma in CWH and HEU, and on interventions to further optimise antenatal and postpartum care in WWH.
在瑞士进行的一项前瞻性、多中心观察性队列研究,旨在调查预防 HIV 感染孕妇母婴传播的措施,并评估其暴露儿童以及一般 HIV 感染儿童(CWH)的健康和发育情况。
1986 年 1 月至 2022 年 12 月期间,共纳入了 1446 对母婴。在此期间,该研究还登记了 187 名 CWH 和 521 名 HIV 暴露但未感染的儿童(HEU),但无法获得这些儿童的详细母婴信息。因此,该队列共包含 2154 名儿童。
在这 37 年中,瑞士母婴 HIV 队列研究(MoCHiV)及其国际合作者的研究强烈影响了 HIV 垂直传播的预防措施(例如,选择性剖宫产术的引入和停止、新生儿暴露后预防和母乳喂养)。在 HEU 和 CWH 的诊断管理(例如,p24 抗原检测)和抗逆转录病毒治疗的效果(例如,早产、生长)方面也做出了贡献。
该队列中目前大多数儿童都是 HEU,这突出表明需要研究其他垂直传播的病原体,如乙型和丙型肝炎病毒、巨细胞病毒或 。此外,计划对 CWH 的纵向健康状况(例如,耐药和长期暴露于抗逆转录病毒治疗)、CWH 和 HEU 的社会方面(包括耻辱感)以及进一步优化 WWH 产前和产后护理的干预措施进行分析。