High HIV incidence during pregnancy: compelling reason for repeat HIV testing
High HIV incidence during pregnancy: compelling reason for repeat HIV testing
复制标题
DOI：
10.1097/qad.0b013e32832a5934
复制
发表时间：
2009-06-19
期刊：
影响因子：
3.8
通讯作者：
Ngaleka, Linda
中科院分区：
文献类型：
--
作者：
Moodley, Dhayendre;Esterhuizen, Tonya M.;Ngaleka, Linda
目的：通过在妊娠后期使用重复的 HIV 快速检测策略来确定妊娠期间 HIV 的发病率。设计：嵌套在预防母婴传播计划中的横断面研究方法：孕妇在妊娠 36 至 40 周之间进行重新检测，前提是她们至少在 3 个月前检测出 HIV 呈阴性。结果：在 2377 名 HIV 阴性女性中，1099 名接受了重新检测(46.2%)和1278人(53.4%)分别在城市和农村卫生机构接受了检测。 72 名女性 (3%) 为 HIV 阳性（679 名女性接触年），艾滋病毒发病率为 10.7/100 名女性年 [95% 置信区间 (CI) 8.2-13.1]。城市设施中妊娠期艾滋病毒感染率较高，但无统计学意义（12.4/100 名女性年 vs 9.1/100 名女性年），25-29 岁和 30-34 岁年龄组的艾滋病毒感染率（分别为 3.8% 和 4.51%）是 20 岁以下年龄组（1.9%）的至少两倍。单身女性在怀孕期间发生血清转化的风险高出 2.5 倍（P = 0.017）。结论：最近的一项调查报告显示，怀孕期间的艾滋病毒感染率是非怀孕人群的四倍。公共卫生规划需要继续加强预防策略和怀孕期间的艾滋病毒重新检测。后者还提供了防止母婴传播和进一步水平传播的额外机会。需要进一步研究来了解妊娠期原发性艾滋病毒感染的原因。 (c) 2009 年 Wolters Kluwer Health 垂直条 Lippincott Williams & Wilkins
objective: To determine the incidence of HIV during pregnancy as defined by seroconversion using a repeat HIV rapid testing strategy during late pregnancy.Design: Cross-sectional study nested in a prevention of mother-to-child transmission programMethods: Pregnant women were retested between 36 and 40 weeks of gestation, provided that they had been tested HIV negative at least 3 months prior.Results: Among the 2377 HIV-negative women retested, 1099 (46.2%) and 1278 (53.4%) were tested at urban and rural health facilities, respectively. Seventy-two women (3%) were HIV-positive (679 woman years of exposure) yielding a HIV incidence rate of 10.7/100 woman years [95% confidence interval (CI) 8.2-13.1]. HIV incidence in pregnancy was higher but not statistically significant at the urban facilities (12.4/100 woman years versus 9.1/100 woman years) and at least two-fold higher among the 25-29 and 30-34-year age groups (3.8 and 4.51%, respectively) as compared with the less than 20-year age group (1.9%). Single women were at 2.5 times higher risk of seroconverting during pregnancy (P = 0.017).Conclusion: HIV incidence during pregnancy is four times higher than in the nonpregnant population reported in a recent survey. Public health programs need to continue to reinforce prevention strategies and HIV retesting during pregnancy. The latter also offers an additional opportunity to prevent mother-to-child transmission and further horizontal transmission. Further research is required to understand the cause of primary HIV infection in pregnancy. (c) 2009 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins