HIV-1/AIDSとアフリカにおける母子保健
François Dabis1, Ehounou René Ekpini
1INSERM U.330, ISPED, Université Victor Segalen, Bordeaux, France. francois.dabis@isped.u-bordeaux.fr
Lancet (London, England)
|June 28, 2002
まとめ
アフリカでは,母から子へのHIV感染を防ぐことが極めて重要です. 抗レトロウイルス治療と教育を含む包括的なケアにより,感染率と幼児死亡率を大幅に減らすことができます.
科学分野:
- 公衆衛生は公衆衛生である.
- 感染症 感染症は感染症です.
- 小児科は小児科です.
背景:
- サハラ以南のアフリカは,小児のヒト免疫不全ウイルス1型 (HIV-1) 感染症の重荷に直面しており,約1900人の子どもが母親から毎日ウイルスに感染しています.
- HIV-1の母から子への感染 (MTCT) のリスクは25~45%の範囲で,重大な子供の死亡率につながり,感染した子供の35~59%が2歳までに死亡する.
研究 の 目的:
- アフリカにおける母から子への感染 (PMTCT) プログラムの拡大防止の緊急性を強調する.
- HIV-1に感染した妊婦とその家族に対する包括的な介護の継続性の重要性を強調する.
主な方法:
- 性的感染の予防,HIV-1検査,家族計画教育,抗レトロウイルス薬による予防を含む,HIV-1MTCTを減らすための現在の戦略のレビュー.
- アフリカ諸国における既存のPMTCTプログラムのアクセシビリティとリーチの評価.
- 抗レトロウイルス療法,コトリモクサゾール予防療法,孤児に対するコミュニティベースの支援などのケアの主な構成要素の議論.
主要な成果:
- 現在,アフリカ13カ国で実施されているPMTCTプログラムは,対象となるHIV-1感染者の3%未満に達しています.
- HIV-1感染児の感染症合併症は,コートリモクサゾール予防で予防できます.
- HIV-1に感染した妊婦には,効果的な抗レトロウイルス療法があります.
結論:
- 母から子へのHIV-1感染の予防は,アフリカで普遍的なケア標準にならなければならない.
- 抗レトロウイルス治療とコミュニティ支援を含む総合的なケアを迅速に拡大することは,MTCTと幼児死亡率を減らすために不可欠です.
- HIV-1感染のリスクをさらに5%以下まで減らすために,継続的な研究が必要である.
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