McDonald A M, Cruickshank M, Ziegler J B, Elliott E, Kaldor J M
National Centre in HIV Epidemiology and Clinical Research, Sydney, NSW.
Med J Aust. 1997 Jan 20;166(2):77-80. doi: 10.5694/j.1326-5377.1997.tb138725.x.
To describe the pattern of perinatal exposure to HIV in Australia from 1 January 1982 to 31 December 1994.
National surveillance for perinatal exposure to HIV.
Women with diagnosed HIV infection in Australia whose children were exposed to HIV perinatally.
Number of reported cases of women with diagnosed HIV infection who have had perinatally HIV-exposed children.
By 31 December 1994, 91 women diagnosed with HIV infection had had 111 perinatally exposed children. While the rate of perinatal exposure to HIV was highest in the Australian Capital Territory and New South Wales, the rate was substantially lower than the rate of diagnoses of HIV and AIDS in women of child-bearing age. Before 1989, only 15% (6/39) of women knew of their HIV infection before the birth of their first perinatally exposed child: by 1989-1994, this had increased to 64% (32/52; P < 0.0005). Overall, exposure to HIV was attributed to heterosexual contact only, injecting drug use or receipt of blood or tissue by 48%, 31% and 18% of women, respectively. Source of HIV exposure changed from a history of receipt of blood in 78% of women whose first exposed child was born in 1982-1985 to heterosexual contact only in 61% of women whose first exposed child was born in 1992-1994. 38 children acquired HIV infection perinatally. The HIV transmission rate to children born to women diagnosed with HIV infection before delivery was 21.6% (11/51).
Perinatal exposure to HIV in Australia remains rare. While the proportion of women diagnosed with HIV infection after delivery decreased, a substantial number continued to be diagnosed after delivery, precluding use of current interventions that can reduce the risk of perinatal transmission. It may be appropriate to review the application of HIV testing during pregnancy in Australia.
描述1982年1月1日至1994年12月31日期间澳大利亚围产期HIV暴露情况。
全国围产期HIV暴露监测。
澳大利亚确诊感染HIV且其子女在围产期暴露于HIV的女性。
报告的确诊感染HIV且其子女在围产期暴露于HIV的女性病例数。
截至1994年12月31日，91名确诊感染HIV的女性生育了111名围产期暴露儿童。虽然澳大利亚首都领地和新南威尔士州的围产期HIV暴露率最高，但该率远低于育龄女性中HIV和艾滋病的诊断率。1989年前，只有15%（6/39）的女性在其首个围产期暴露儿童出生前知晓自己感染了HIV；到1989 - 1994年，这一比例增至64%（32/52；P < 0.0005）。总体而言，分别有48%、31%和18%的女性将HIV暴露归因于异性接触、注射吸毒或接受血液或组织。HIV暴露源从1982 - 1985年出生的首个暴露儿童的母亲中78%有输血史，变为1992 - 1994年出生的首个暴露儿童的母亲中61%仅有异性接触。38名儿童在围产期感染了HIV。分娩前确诊感染HIV的女性所生子女的HIV传播率为21.6%（11/51）。
澳大利亚围产期HIV暴露仍然罕见。虽然分娩后确诊感染HIV的女性比例有所下降，但仍有相当数量的女性在分娩后被确诊，这使得无法采用当前可降低围产期传播风险 的干预措施。或许有必要审视澳大利亚孕期HIV检测的应用情况。
