National audit of perinatal HIV infections in the UK, 2006-2013: what lessons can be learnt?
National audit of perinatal HIV infections in the UK, 2006-2013: what lessons can be learnt?
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作者：
Peters H;Thorne C;Tookey PA;Byrne L
这项研究的目的是调查英国围产期艾滋病毒（PHIV）传播的情况。全国妊娠期和儿童期艾滋病毒研究对英国所有被诊断为艾滋病毒感染的妇女及其婴儿的妊娠进行全面监测;还寻求所有被诊断为艾滋病毒的儿童的报告，无论其出生国如何。2006-2013年出生并于2014年报告的PHIV儿童被纳入审计，并通过电话采访参与每个病例的临床医生收集额外数据。确定了每种传播的促成因素，并根据主要可能的促成因素，按母亲诊断时间描述病例。共发现108个潜在感染者。在41名（38%）婴儿的母亲在分娩前被诊断出，很可能大多数是在子宫内感染，约20%是在分娩期间感染，20%是通过母乳喂养感染。对于大多数未确诊母亲的孩子来说，传播的时间是未知的。对于确诊妇女所生的婴儿，最常见的传播因素是怀孕期间难以参与和/或坚持抗逆转录病毒治疗（ART）（41人中的14人）和产前预约（41人中的9人）;对于67名母亲未确诊的儿童，这些因素是艾滋病毒检测下降（67人中的28人）和血清转化（67人中的23人）。据报告，53%的妇女在怀孕期间面临不利的社会环境，包括移民身份不确定、住房问题和亲密伴侣暴力。8名儿童死亡，均为未确诊的母亲所生。需要改进的优先领域包括减少意外感染，提高抗逆转录病毒疗法的坚持率，促进更好地参与护理，并注意解决这些妇女面临的健康不平等和不利的社会状况。
The aim of the study was to investigate circumstances surrounding perinatal transmissions of HIV (PHIVs) in the UK. The National Study of HIV in Pregnancy and Childhood conducts comprehensive surveillance of all pregnancies in women diagnosed with HIV infection and their infants in the UK; reports of all HIV‐diagnosed children are also sought, regardless of country of birth. Children with PHIV born in 2006–2013 and reported by 2014 were included in an audit, with additional data collection via telephone interviews with clinicians involved in each case. Contributing factors for each transmission were identified, and cases described according to main likely contributing factor, by maternal diagnosis timing. A total of 108 PHIVs were identified. Of the 41 (38%) infants whose mothers were diagnosed before delivery, it is probable that most were infected in utero, around 20% intrapartum and 20% through breastfeeding. Timing of transmission was unknown for most children of undiagnosed mothers. For infants born to diagnosed women, the most common contributing factors for transmission were difficulties with engagement and/or antiretroviral therapy (ART) adherence in pregnancy (14 of 41) and late antenatal booking (nine of 41); for the 67 children with undiagnosed mothers, these were decline of HIV testing (28 of 67) and seroconversion (23 of 67). Adverse social circumstances around the time of pregnancy were reported for 53% of women, including uncertain immigration status, housing problems and intimate partner violence. Eight children died, all born to undiagnosed mothers. Priority areas requiring improvement include reducing incident infections, improving ART adherence and facilitating better engagement in care, with attention to addressing the health inequalities and adverse social situations faced by these women.
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影响因子：
15.8
作者：
Mills EJ;Nachega JB;Bangsberg DR;Singh S;Rachlis B;Wu P;Wilson K;Buchan I;Gill CJ;Cooper C
通讯作者：
Cooper C
DOI：
10.1056/nejmoa0911486
发表时间：
2010-06-17
期刊：
The New England journal of medicine
影响因子：
--
作者：
Chasela CS;Hudgens MG;Jamieson DJ;Kayira D;Hosseinipour MC;Kourtis AP;Martinson F;Tegha G;Knight RJ;Ahmed YI;Kamwendo DD;Hoffman IF;Ellington SR;Kacheche Z;Soko A;Wiener JB;Fiscus SA;Kazembe P;Mofolo IA;Chigwenembe M;Sichali DS;van der Horst CM;BAN Study Group
通讯作者：
BAN Study Group
影响因子：
3.7
作者：
Raffe, S.;Curtis, H.;Gilleece, Y.
通讯作者：
Gilleece, Y.
影响因子：
3
作者：
French CE;Thorne C;Byrne L;Cortina-Borja M;Tookey PA
通讯作者：
Tookey PA
影响因子：
3.6
作者：
Marazzi, Maria Cristina;Nielsen-Saines, Karin;Palombi, Leonardo
通讯作者：
Palombi, Leonardo