Risk factors of HIV vertical transmission in a cohort of women under a PMTCT program at three peri-urban clinics in a resource-poor setting
Risk factors of HIV vertical transmission in a cohort of women under a PMTCT program at three peri-urban clinics in a resource-poor setting
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DOI：
10.1038/jp.2010.31
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发表时间：
2010-11-01
影响因子：
2.9
通讯作者：
Stray-Pedersen, B.
中科院分区：
文献类型：
--
作者：
Gumbo, F. Z.;Duri, K.;Stray-Pedersen, B.
目的：探讨孕妇HIV垂直传播的危险因素。研究设计：观察性队列研究。2002年至2003年期间，479名感染艾滋病毒的孕妇参加了预防母婴传播（PMTCT）方案，在分娩时对她们的婴儿进行了跟踪，直到15个月大时进行婴儿艾滋病毒检测。结果：在这281名婴儿中，15个月大的婴儿有明确的艾滋病毒检测结果，31.7%的婴儿感染艾滋病毒。在单因素分析中，确定的危险因素是入组时母亲存在阴道分泌物、生殖器瘙痒、生殖器溃疡、排尿困难、乳房异常和阴道感染（滴虫病、细菌性阴道病和念珠菌病）。多因素分析中，阴道感染风险比（RR） 1.72（1.03 ~ 2.88）、乳房异常风险比（RR） 4.36（2.89 ~ 6.58）是HIV垂直传播的预测因子。结论：有必要筛查阴道感染（滴虫病、细菌性阴道病和念珠菌病），并检查孕妇是否患有乳腺炎，以确定HIV垂直传播的高危妇女，并进行预防。围产期杂志（2010）30,717-723；doi: 10.1038 / jp.2010.31;2010年3月25日在线发布
Objective: To identify the risk factors of HIV vertical transmission in pregnant women.Study Design: Observational cohort study. Between 2002 and 2003, 479 HIV-infected pregnant women in a PMTCT (prevention of the mother-to-child transmission) program were followed up with their infants at delivery, until 15 months with infant HIV testing.Results: Of these 281 infants had a definitive HIV result by 15 months of age, and 31.7% of the infants become HIV infected. In univariate analysis the risk factor identified were presence of vaginal discharge, genital itchiness, genital ulcers, dysuria, abnormal breast and vaginal infections (Trichomonas, Bacteria vaginosis and Candida) in the mother at enrolment. In multivariate analysis vaginal infections risk ratio (RR) 1.72(1.03-2.88) and abnormal breast RR 4.36(2.89-6.58) were predictors of HIV vertical transmission.Conclusion: There is need to screen for vaginal infections (Trichomonas, Bacteria vaginosis and Candida) and examine pregnant women for mastitis to identify women at risk of HIV vertical transmission for prevention. Journal of Perinatology (2010) 30, 717-723; doi:10.1038/jp.2010.31; published online 25 March 2010