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获得性免疫缺陷综合征患者及其伴侣的妊娠状态评估。

Assessment of Pregnancy Status in Patients with Acquired Immunodeficiency Syndrome and their Partners.

作者信息

Cabalak Mehmet, Karapınar Oya Soylu, El Cigdem

机构信息

Department of İInfectious Disease and Clinical Microbiology, Mustafa Kemal University, Antakya, Turkey.

Department of Gynecology and Obstetrics, Mustafa Kemal University, Antakya, Turkey.

出版信息

Curr HIV Res. 2024;22(6):402-408. doi: 10.2174/011570162X349194241125052104.

DOI:10.2174/011570162X349194241125052104
PMID:39629575
Abstract

BACKGROUND

HIV is a globally prevalent infection for which there is currently no cure or vaccine. As the number of individuals with HIV infection increases, so does the number of individuals wishing to have children despite being infected. This situation has highlighted issues related to couples where one partner is infected while the other is not (serodiscordant couples) and couples where both partners are positive. Major issues include pregnancy complications, transmission to the child, and potential side effects of the ART treatment on the health of the child. Women living with HIV who become pregnant or contract the virus during pregnancy are at risk for both maternal and perinatal morbidity and mortality, especially if the virus is not adequately controlled. Additionally, there is a risk of vertical transmission through breastfeeding during pregnancy and postpartum. To mitigate the consequences of HIV during pregnancy, it is ideal to start with prepregnancy counseling and plan pregnancies during periods of minimal viral load using appropriate methods.

AIMS AND OBJECTIVE

There are limited studies and shared experiences regarding fertility status and issues of HIV/AIDS patients, especially in Turkey. Hence, this study aimed to investigate the fertility status of HIV/AIDS patients and their partners followed up in our clinic, shed light on the encountered issues, and share our experiences.

METHODS

This retrospective, observational, single-center cross-sectional study included HIV/AIDS patients and their partners followed at Hatay Mustafa Kemal University (MKÜ) Medical Faculty Hospital from January 2018 to December 2023. Demographic data of the patients, their sexual orientations, HIV/AIDS status of their partners and children, treatments received, CD4 cell counts, and viral load data were retrospectively obtained from the automation system of our hospital and patient files.

RESULTS

Among the couples, there were 21 pairs where both partners were HIV positive, 10 pairs where the woman was HIV positive and the man was seronegative (serodiscordant), and 5 pairs where the man was HIV positive and the woman was seronegative. In our study, eight couples with both partners HIV positive had nine children, and six couples with women who were HIV positive (serodiscordant) had ten children. The five couples with men who were HIV positive (serodiscordant) had six children. No vertical transmission was observed in our study, but three patients did not attend regular follow-ups. During the follow-up period, no seroconversion was detected in the partners of serodiscordant patients. The average gestational age was 38 weeks, and the average birth weight was 2873 ± 349 grams.

CONCLUSION

Our study found no vertical transmission and no seroconversion in partners of serodiscordant couples. Issues related to pregnancy in HIV-positive couples can be managed with pre-pregnancy counseling by specialists, protective methods, appropriate ART, and perinatal follow- up.

摘要

背景

艾滋病毒是一种全球流行的感染性疾病,目前尚无治愈方法或疫苗。随着艾滋病毒感染者数量的增加,尽管感染了病毒但仍希望生育的人数也在增加。这种情况凸显了一些与伴侣相关的问题,其中一方感染而另一方未感染(血清学不一致的伴侣)以及双方均为阳性的伴侣。主要问题包括妊娠并发症、传染给孩子以及抗逆转录病毒治疗对孩子健康的潜在副作用。感染艾滋病毒的女性在怀孕期间怀孕或感染病毒,母婴和围产期均有发病和死亡风险,特别是如果病毒未得到充分控制。此外,在怀孕期间和产后通过母乳喂养存在垂直传播的风险。为减轻怀孕期间艾滋病毒的后果,理想的做法是从孕前咨询开始,并在病毒载量最低的时期使用适当方法计划怀孕。

目的

关于艾滋病毒/艾滋病患者的生育状况和问题的研究及共享经验有限,尤其是在土耳其。因此,本研究旨在调查在我们诊所接受随访的艾滋病毒/艾滋病患者及其伴侣的生育状况,阐明所遇到的问题,并分享我们的经验。

方法

这项回顾性、观察性、单中心横断面研究纳入了2018年1月至2023年12月在哈塔伊穆斯塔法·凯末尔大学(MKÜ)医学院医院接受随访的艾滋病毒/艾滋病患者及其伴侣。患者的人口统计学数据、性取向、其伴侣和孩子的艾滋病毒/艾滋病状况、接受的治疗、CD4细胞计数和病毒载量数据均从我院自动化系统和患者档案中回顾性获取。

结果

在这些伴侣中,双方均为艾滋病毒阳性的有21对,女性艾滋病毒阳性而男性血清学阴性(血清学不一致)的有10对,男性艾滋病毒阳性而女性血清学阴性的有5对。在我们的研究中,双方均为艾滋病毒阳性的8对伴侣育有9个孩子,女性艾滋病毒阳性(血清学不一致)的6对伴侣育有10个孩子。男性艾滋病毒阳性(血清学不一致)的5对伴侣育有6个孩子。在我们的研究中未观察到垂直传播,但有3名患者未定期随访。在随访期间,血清学不一致患者的伴侣未检测到血清转化。平均孕周为38周,平均出生体重为2873±349克。

结论

我们的研究发现血清学不一致的伴侣中没有垂直传播和血清转化。艾滋病毒阳性伴侣的妊娠相关问题可以通过专家的孕前咨询、保护方法、适当的抗逆转录病毒治疗和围产期随访来管理。

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