摘要
目的分析艾滋病病毒(HIV)抗体阳性的产妇乳汁中病毒载量及与血浆病毒载量的相关性;分析抗病毒治疗(ART)对血浆病毒载量和乳汁病毒载量影响;为HIV抗体阳性母亲是否进行母乳喂养提供参考依据。方法以2016年3月至2019年6月期间,孕期或产时才发现感染HIV的产妇为研究对象,检测产妇产时乳汁和血浆HIV病毒载量,采用配对秩和检验分析血浆和乳汁中病毒载量差异,采用单因素Logistic回归和Spearman rank相关分析血浆病毒载量和乳汁病毒载量的相关性,采用Wilcoxon秩和检验分析ART对血浆病毒载量和乳汁病毒载量影响。结果共纳入84例研究对象,其中18例乳汁中能检测到HIV病毒载量,检出率为21.4%,77例血浆中能检测到病毒载量,检出率为91.7%。血浆病毒载量<100拷贝/mL的产妇,乳汁中病毒载量检测不到。乳汁病毒载量低于血浆病毒载量,二者差异有统计学意义(P <0.001)。乳汁中病毒载量和血浆中病毒载量为正相关关系(P=0.020),相关系数为0.253。接受ART的产妇血浆病毒载量低于未接受ART的产妇,差异有统计学意义(P=0.040),但乳汁病毒载量差异无统计学意义(P=0.521)。结论部分HIV抗体阳性产妇乳汁中能检测到HIV病毒载量,提示HIV抗体阳性产妇母乳喂养存在母婴传播的风险,乳汁中病毒载量与血浆中病毒载量为正相关关系。HIV抗体阳性产妇是否能进行母乳喂养需要结合产妇病毒是否完全抑制、社会、环境、宗教等多个因素综合决定。
Objective To analyze the viral load in breast milk and the correlation between viral load in plasma and breast milk among mothers living with HIV/AIDS;to analyze the effect of antiviral therapy(ART) on plasma and breast milk viral load;and to provide reference for HIV positive mothers for breastfeeding. Methods Maternal plasma and breast milk samples were collected between March 2016 and June 2019 during delivery of women living with HIV/AIDS. HIV viral load in breast milk and plasma were tested. The difference between viral load in breast milk and plasma was analyzed by Wilcoxon matched-pairs signed-ranks test, and the relationship between viral load in breast milk and plasma was analyzed by single factor logistic regression and Spearman’s rank correlation analysis. Results A total of 84 women were included in our study. 18 of them had a detectable viral load in breast milk. The positive rate was 21.4%, and 77 of them had a detectable viral load in plasma. The positive rate was 91.6%. In patients with plasma viral load < 100 copies/m L, the viral load in breast milk was not detectable. The viral load in breast milk was less than the viral load in plasma(P < 0.001), and they had a significant positive correlation(P =0.020), with the coefficient of 0.253. The plasma viral load of the mothers with ART was lower than that of the mothers without ART(P =0.040). However, the breast milk viral load was not significantly different(P=0.521). Conclusion The viral load can be detected in breast milk in mothers living with HIV/AIDS.There is a significant positive correlation between the viral load in breast milk and plasma. There is a risk of mother-to-child transmission if mothers living with HIV/AIDS have breastfeeding. Whether HIV positive mothers should breastfeed requires comprehensive consideration.
作者
徐晴晴
邓煜川
李珍
王爱玲
姚均
XU Qingqing;DENG Yuchuan;LI Zhen;WANG Ailing;YAO Jun(National Center for AIDS/STD Control and Prevention,Center for Disease Control and Prevention of China,Beijing 102206,China;National Center for Women and Children’s Health,Center for Disease Control and Prevention of China,Beijing 100013)
出处
《中国艾滋病性病》
CAS
CSCD
北大核心
2020年第5期476-478,521,共4页
Chinese Journal of Aids & STD
基金
国家科技重大专项(2015ZX10001001-002)
国家“十三五”重大专项(2018ZX10732101-001-010)。
关键词
艾滋病
乳汁
血浆
病毒载量
HIV/AIDS
breast milk
plasma
viral load
