【摘要】 目的探索预防艾滋病母婴传播关键技术,降低艾滋病母婴传播率.方法采用流行病学现场干预试验,探索提高孕妇艾滋病自愿咨询检测率的措施.采用临床研究方法开展艾滋病母婴传播干预实验研究,将艾滋病病毒(HIV)感染孕产妇随机分为两组,分别给予HIV感染孕产妇及其所生新生儿两种抗反转录病毒药物方案(齐多夫定(AZT)与耐韦拉平(NVP)联合方案和单一NVP方案)阻断治疗,并实施住院分娩、人工喂养等措施.结果获得了促进农村妇女孕早、中期HIV抗体自愿咨询检测综合策略.通过干预,研究点妇女孕28周前HIV抗体检测率、孕28周前自愿咨询检测率分别上升了50.4%和60.9%;研究点研究期间接受HIV母婴阻断系列服务122例,完成112例婴儿追踪随访,阻断成功107例,阻断成功率达到95.5%,AZT+NVP联合方案母婴传播率降至1.8%,单一NVP方案母婴传播率降至7.0%.结论促进农村妇女孕早、中期HIV抗体自愿咨询检测综合措施与抗病毒治疗,结合住院分娩和婴儿人工喂养能显著地降低艾滋病母婴传播率.更多还原

【Abstract】 Objective To explore the key technique to prevent mother-to-child transmission of HIV in rural areas, so as to reduce transmission rate of HIV from mother to child.Methods Epidemiological spot-intervention experiment was used to explore countermeasures to improve voluntary counseling and testing for HIV in pregnant women.A randomized trial of two regimens (regimen of zidovudine plus nevirapine,regimen of single-dose nevirapine) of antiretrovirous therapy (ART) was conducted in HIV positive pregnant women and their infants.All women were hospital delivery, and their infants received formular fedding.Results Integrated countermeasures to promote pregnant women receiving HIV voluntary counseling and testing (VCT) in the first and second trimester of pregnancy was obtained from spot study.Through the intervention,the rate of HIV testing before 28 weeks of pregnancy,and rate of HIV VCT before 28 weeks of pregnancy increased by 50.4% and 60.9% respectively.During the study period,122 pregnant women with HIV positive were enrolled in the trial.61 cases received zidovudine plus nevirapine therapy,and other 61 cases received single-dose nevirapinetherapy.As result,112 infants were completed follow up visiting,107 cases were successfully interdicted, with the successful interdiction rate 95.5%. Mother-to-child transmission rate decreased to 1.8% in the regimen of zidovudine plus nevirapine and decreased to 7.0% in single-dose nevirapine regimen.Conclusions The integrated countermeasures to promote pregnant women receiving HIV voluntary counseling and testing,and the ART with hospital delivery and infant formular feeding can significantly reduce transmission rate of HIV from mother to child.更多还原