Effectiveness and associated factors of prevention for mother-to-child human immunodeficiency virus transmission in 536 human immunodeficiency virus-positive pregnant women in Hubei Province / 中华传染病杂志

ABSTRACT

Objective To evaluate the effectiveness and associated factors of prevention of motherto-child human immunodeficiency virus (HIV) transmission in Hubei Province,and to provide a reference for prevention of mother-to-child transmission of HIV.Methods In this prospective cohort study,HIV-positive pregnant women who were in some counties and cities of Hubei Province from January 2004 to December 2016 were enrolled.Prevention of mother-to-child transmission of HIV was conducted for these HIV-positive pregnant women and their infants,and their clinical data were collected.Descriptive analysis and x2 test were used to analyze the general characteristics of HIV-positive pregnant women and their infants.Logistic regression analysis was adopted to explore the associated factors of mother-to-child HIV transmission.Results In total,536 HIV-positive pregnant women (628 pregnancies) were found,among which,334 pregnant women and 345 infants were enrolled in this study.Twenty-four infants were HIV-positive,which was 6.96％ in all infants (95％CI4.27％-9.64％).The rates of mother-to-child HIV transmission without prevention,formula feeding only,infant medication plus formula feeding,mother and infant medication plus formula feeding were 35.71％ (95％CI21.61％-51.93％),8.82％ (95％CI2.08％-15.57％),7.41％ (95％CI0.92％-24.22％),and0.48％ (95％CI0.01％-2.64％),respectively.No antiretroviral medications during delivery (OR =14.484,95 ％CI1.740-120.577,P=0.013),breastfeeding (OR=6.542,95％CI2.416-17.713,P=0.000),and CD4-T lymphocyte count＜200 cells/μL during delivery (OR=3.060,95％CI1.076-8.703,P=0.036) were independent risk factors of mother-to-child HIV transmission.Conclusions The rate of mother-to-child HIV transmission without prevention is high in Hubei Province,which can be significantly reduced by comprehensive interventions (mother and infant medication plus formula feeding).Thus,we should diagnose HIV-positive pregnant women as early as possible,and should give pregnant woman antiretroviral therapy plus infant medication and formula feeding to further reduce the rate of mother-to-child HIV transmission.