Blanche S
Département de pédiatrie, hôpital des Enfants Malades, Paris.
Rev Prat. 1994 Jun 15;44(12):1603-10.
Four hundred to 600 pregnancies have now been carried to full-term by HIV seropositive women in France. The rate of transmission of the virus to the infant is around 20%, and there remains much uncertainty concerning the exact mechanism involved. Early diagnostic methods are based on isolating the virus in culture or PCR but the sensitivity of this test is only 50% at birth, although rising to nearly 100% by 6 months of age. In the infant, the main characteristic of the disease is the existence of a subgroup (comprising 15 to 20% of the patients) that develops AIDS early, in association with opportunistic infection and encephalopathy in the first months of life. Treatment choices remain very limited, with the hope of eventual prevention of maternal-fetal transmission. The gravity of the ensuing psychological and social problems calls for a multidisciplinary approach to the infant, family and relatives.
目前,法国已有400至600名HIV血清反应阳性的女性怀孕至足月。病毒传播给婴儿的比率约为20%,而且对于其中确切的机制仍存在诸多不确定性。早期诊断方法是基于在培养物中分离病毒或进行聚合酶链反应(PCR),但该检测在婴儿出生时的灵敏度仅为50%,不过到6个月大时会升至近100%。在婴儿中,该疾病的主要特征是存在一个亚组(占患者的15%至20%),这些婴儿在生命的最初几个月就会早早患上艾滋病,并伴有机会性感染和脑病。治疗选择仍然非常有限,寄希望于最终预防母婴传播。随之而来的心理和社会问题的严重性要求对婴儿、家庭和亲属采取多学科方法。