Reduction in mother-to-child transmission of HIV in Thailand, 2001-2003: results from population-based surveillance in six provinces
Reduction in mother-to-child transmission of HIV in Thailand, 2001-2003: results from population-based surveillance in six provinces
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DOI：
10.1097/qad.0b013e328010e02d
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发表时间：
2007-01-11
期刊：
影响因子：
3.8
通讯作者：
Culnane, Mary
中科院分区：
文献类型：
--
作者：
Plipat, Tanarak;Naiwatanakul, Thananda;Culnane, Mary
工作背景：在2000年，泰国实施了一项国家计划，以防止母婴艾滋病毒传播（PMTCT）。目的：描述预防母婴艾滋病毒传播计划在Thailand.Design和方法的有效性：艾滋病毒暴露的儿童出生时的登记与感染状态的后续行动。登记册包括2001年1月1日至2003年12月31日期间在泰国六个省的84家公共卫生医院由感染艾滋病毒的妇女所生的子女。主要结果措施是艾滋病毒感染的儿童。结果：共2200名儿童出生的艾滋病毒感染的母亲进行了登记。在这些母婴对中，2105例（95.7%）接受了一些抗逆转录病毒预防，其中1358例（61.7%）在母亲妊娠和分娩期间以及婴儿出生后接受了完整的短程齐多夫定方案，伴或不伴其他抗逆转录病毒药物。确定了1667名（75.8%）儿童的HIV感染结局，其中158名[9.5%，95%置信区间（0），8.1-11.0%]被感染。在761对单独接受完整齐多夫定方案的母婴对中，传播风险为6.8%（95%CI 5.2-8.9%），在361对接受完整齐多夫定方案联合其他抗逆转录病毒药物（通常为奈韦拉平）的母婴对中，传播风险为3.9%（95%CI，2.2-6.6%）。该队列的总体传播风险（包括所有抗逆转录病毒预防组合）估计为10.2%。结论：泰国国家预防母婴传播计划有效降低了母婴传播风险，其历史风险为18.9- 24.2%。从2004年开始，在短程齐多夫定中加入奈韦拉平可能会进一步提高泰国项目的有效性。(c)2007年利平科特威廉姆斯&威尔金斯。
Background: In 2000, Thailand implemented a national program to prevent mother-to-child HIV transmission (PMTCT).Objective: To describe the effectiveness of the prevention of mother-to-child HIV transmission program in Thailand.Design and methods: A register of HIV-exposed children at birth was created with follow-up of infection status. The register included children born to HIV-infected women between I January 2001 and 31 December 2003 at 84 public health hospitals in six provinces of Thailand. The main outcome measure was HIV infection in children.Results: A total of 2200 children born to HIV-infected mothers were registered. Of these mother-infant pairs, 2105 (95.7%) received some antiretroviral prophylaxis, including 1358 (61.7%) who received the complete short-course zidovudine regimen during pregnancy and labor for the mother and after birth for the infant, with or without other antiretrovirals. HIV infection outcome was determined for 1667 (75.8%) children, of whom 158 [9.5%, 95% confidence interval (0), 8.1-11.0%] were infected. Transmission risk was 6.8% (95% Cl 5.2-8.9%) among 761 mother-infant pairs that received the complete zidovudine regimen alone, and 3.9% (95% Cl, 2.2-6.6%) among 361 mother-infant pairs that received the complete zidovudine regimen combined with other anti retrovirals, usually nevirapine. The overall transmission risk from this cohort, including all antiretroviral prophylaxis combinations, is estimated to be 10.2%.Conclusions: The Thai national PMTCT program is effective in reducing mother-to-child transmission risk from the historical risk of 18.9-24.2%. The addition of nevirapine to short-course zidovudine beginning in 2004 may further improve program effectiveness in Thailand. (c) 2007 Lippincott Williams & Wilkins.