印度在消除艾滋病毒垂直传播方面取得的进展与面临的挑战。

Progress and challenges towards eliminating vertical transmission of HIV in India.

作者信息

Kumar Pradeep, Das Chinmoyee, Deo Vishal, Chaturvedi Himanshu K, Biswas Subrata, Priyam Nidhi, Kharayat Lalit Singh, Rai Sanjay K, Godbole Sheela V, Arumugam Elangovan, Lakshmi P V M, Dutta Shanta, Devi H Sanayaima, Bhardwaj Pankaj, Singh Arvind Kumar, Shinde Rashmi, Sahu Damodar, Kant Shashi, Reddy Dandu Chandra Sekhar, Mehendale Sanjay, Rajan Shobini

机构信息

Ministry of Health and Family Welfare, National AIDS Control Organization, New Delhi, India.

Indian Council of Medical Research, National Institute of Medical Statistics, New Delhi, India.

出版信息

Sci Rep. 2025 Jul 11;15(1):25004. doi: 10.1038/s41598-025-09481-2.

DOI:10.1038/s41598-025-09481-2

PMID:40640342

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12246464/

Abstract

India has intensified efforts towards elimination of vertical transmission of HIV (EVTH) as part of National AIDS and STD Control Programme-V (NACP-V). We present the progress in achieving NACP-V's EVTH goal as of year 2023-24. We analysed the 2023 state level data using Spectrum model in 2023 to measure the coverage of anti-retroviral treatment among pregnant women, annual paediatric HIV case incidence rate and final vertical transmission rate. UNAIDS and WHO definitions for these indicators were used. In 2023, around 2350 new paediatric infections were estimated by vertical transmission. However, 44% of these transmissions resulted from incident HIV infections among pregnant and breastfeeding women. Overall, paediatric HIV incidence per 100,000 live births decreased from 25.2 (14.7-46.6) in 2019 to 10.4 (6.1-19.3) in 2023. During the same reference period, final vertical transmission rate (inclusive of breastfeeding period) decreased from 25.28% (17.06-37.99) in 2019 to 11.75% (7.93-17.66) in 2023. The 2023 India HIV estimates, using recent data and global modelling tools, highlighted progress in eliminating vertical transmission of HIV. Early identification of HIV-positive mothers and starting them on lifelong ART is crucial. Additionally, generating local evidence is needed on interventions like safe practices, repeat testing, and feeding practices to inform policy decisions.

摘要

作为国家艾滋病和性传播疾病控制计划五（NACP-V）的一部分，印度加大了消除艾滋病毒垂直传播（EVTH）的力度。我们介绍了截至2023-2024年实现NACP-V的EVTH目标的进展情况。我们在2023年使用Spectrum模型分析了2023年的州级数据，以衡量孕妇抗逆转录病毒治疗的覆盖率、年度儿童艾滋病毒病例发病率和最终垂直传播率。使用了联合国艾滋病规划署和世界卫生组织对这些指标的定义。2023年，估计约有2350例儿童新感染是由垂直传播导致的。然而，其中44%的传播是由孕妇和哺乳期妇女感染艾滋病毒所致。总体而言，每10万例活产儿中的儿童艾滋病毒发病率从2019年的25.2（14.7-46.6）降至2023年的10.4（6.1-19.3）。在同一参考期内，最终垂直传播率（包括母乳喂养期）从2019年的25.28%（17.06-37.99）降至2023年的11.75%（7.93-17.66）。2023年印度艾滋病毒估计数利用最新数据和全球建模工具，突出了在消除艾滋病毒垂直传播方面取得的进展。早期识别艾滋病毒阳性母亲并让她们开始终身抗逆转录病毒治疗至关重要。此外，需要就安全做法、重复检测和喂养做法等干预措施生成本地证据，为政策决策提供依据。