Earlier initiation of ART and further decline in mother-to-child HIV transmission rates, 2000-2011
Earlier initiation of ART and further decline in mother-to-child HIV transmission rates, 2000-2011
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DOI：
10.1097/qad.0000000000000212
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发表时间：
2014-04-24
期刊：
影响因子：
3.8
通讯作者：
Tookey, Pat A.
中科院分区：
文献类型：
--
作者：
Townsend, Claire L.;Byrne, Laura;Tookey, Pat A.
Objectives：To analyze mother-to-child HIV transmission（MTCT）rates over time in light of changes in management，demographic，and pregnancy characteristics.Design：Population-based monitoring data on diagnosed HIV-阳性women and their infants are routinely collected in the UK and爱尔兰.Methods：A total 12 486 singleton pregnancy delivered in 2000-2011.结果：母婴传播率从2000-2001年的2.1%（17/816）下降到2010 - 2011年的0.46%（9/1975，95%可信区间：0.21-0.86%）（趋势，P = 0.01），这是由于包括早期开始产前联合抗逆转录病毒治疗（cART）在内的多种因素共同作用的结果。排除63名母乳喂养或出生后感染HIV的婴儿，病毒载量在50-399拷贝/ml的妇女（1.0%，14/1349）的所有分娩方式的母婴传播风险显著高于病毒载量低于50拷贝/ml的妇女（0.09%，6/6347，P
Objectives:To analyze mother-to-child HIV transmission (MTCT) rates over time in light of changes in management, demographic, and pregnancy characteristics.Design:Population-based surveillance data on diagnosed HIV-positive women and their infants are routinely collected in the UK and Ireland.Methods:A total of 12 486 singleton pregnancies delivered in 2000-2011 were analyzed. HIV infection status was available for 11 515 infants (92.2%).Results:The rate of MTCT declined from 2.1% (17/816) in 2000-2001 to 0.46% (nine of 1975, 95% confidence interval: 0.21-0.86%) in 2010-2011 (trend, P = 0.01), because of a combination of factors including earlier initiation of antenatal combination antiretroviral therapy (cART). Excluding 63 infants who were breastfed or acquired HIV postnatally, MTCT risk was significantly higher for all modes of delivery in women with viral load of 50-399 copies/ml (1.0%, 14/1349), compared with viral load of less than 50 copies/ml (0.09%, six of 6347, P