HIV感染に対する定期的な産前スクリーニング
M Barbacci1, J T Repke, R E Chaisson
1Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Lancet (London, England)
|March 23, 1991
まとめ
妊婦におけるヒト免疫不全ウイルス (HIV) の標的型スクリーニングは,症例の40%以上を逃した. すべての妊婦のHIV検査は,検出率を大幅に改善し,母と乳児の健康状態を改善します.
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.
- 産婦人科と産婦人科を担当しています.
背景:
- 先進国の現在のガイドラインは,特定された危険因子に基づいて,妊婦のヒト免疫不全ウイルス (HIV) 検査を推奨しています.
- このリスク因子に基づくアプローチは,妊婦集団におけるHIVの血清流行の全範囲を効果的に捉えることはできません.
研究 の 目的:
- 妊娠中の女性における普遍的なスクリーニングと対照的に,リスクファクター指向のHIVスクリーニングの有効性を評価する.
- 都市圏の妊婦の検出率に対する HIV 検査の影響を調べる.
主な方法:
- 米国ボルチモアで2724人の妊婦を対象に前向きな研究が行われました.
- この研究では,リスクファクターベースのスクリーニングと普遍的なスクリーニングでHIV陽性女性の予測検出率を比較しました.
- すべての参加者にはカウンセリングとHIV検査が提供されました.
主要な成果:
- リスクファクターに基づくスクリーニングガイドラインを適用すれば,HIV陽性妊娠女性の57%しか特定できなかったでしょう.
- 普遍的なカウンセリングとHIV検査を提供することで,検出率は87%に増加しました.
- 妊婦のHIV感染の有意な割合は,標的スクリーニング方法によって見逃された.
結論:
- 妊婦のHIV検査は,認められた危険因子のみに基づいて行うが,有効な症例検出には不十分である.
- 感染者の特定を改善するために,すべての妊婦のHIV検査を定期的に行うことが推奨されています.
- 妊娠中の普遍的なHIV検査は,適切な介入と母子感染の予防に不可欠です.
関連する概念動画
Stages of Infection
Stages of infection describe what happens to a susceptible host once a pathogen invades the human body. The stages of infection are incubation, prodromal, illness, stage of decline, and convalescence. The incubation stage is the period from exposure to a pathogen until symptoms start. The infected person is unaware of impending illness as the pathogens grow and multiply within the body. The duration may vary depending on the type of infection. The incubation period of measles averages ten to...
Poliomyelitis
Poliomyelitis is caused by poliovirus, a small, non-enveloped, positive-sense RNA virus of the Picornaviridae family and Enterovirus genus. Transmission occurs primarily via the fecal-oral route, often through ingestion of contaminated water or food. The virus initially replicates in the oropharynx and intestinal mucosa, particularly in lymphoid tissues such as the tonsils, Peyer’s patches, and regional lymph nodes. Primary viremia follows, allowing dissemination throughout the body.In most...
Cytomegalovirus Disease
Cytomegalovirus (CMV) disease is caused by human cytomegalovirus, a double-stranded DNA virus of the Herpesviridae family. While primary CMV infection is often asymptomatic in immunocompetent individuals, the virus can cause severe disease in neonates and immunocompromised patients. CMV is the most common cause of congenital viral infection in the United States, and a major pathogen in solid organ and hematopoietic stem cell transplant recipients.CMV is transmitted via bodily fluids, sexual...
Hepatitis
Hepatitis is an inflammatory condition of the liver most commonly caused by hepatotropic viruses (A–E), though non-infectious causes such as alcohol and drugs also exist.Hepatitis AHepatitis A virus (HAV) is a non-enveloped RNA virus of the Picornaviridae family. It is primarily transmitted via the fecal-oral route, typically through ingestion of contaminated food or water. After ingestion, HAV enters the bloodstream through the oropharynx or intestinal epithelium and reaches the liver. The...
Genital Herpes
Genital herpes is a sexually transmitted infection primarily caused by herpes simplex virus type 2 (HSV-2), though herpes simplex virus type 1 (HSV-1) is increasingly implicated in genital infections, particularly among younger populations. Transmission occurs mainly through sexual contact, with asymptomatic viral shedding serving as a major route of spread. This characteristic makes HSV-2 difficult to control at a population level, as individuals may unknowingly transmit the virus even in the...
Viral Hepatitis I: Introduction
Viral hepatitis is an inflammatory condition of the liver caused by infection with hepatotropic viruses, most commonly hepatitis A, B, C, D, and E. Despite variations in structure and transmission, all viruses mentioned infect hepatocytes and provoke immune responses that can hinder liver function. Additionally, some non-hepatotropic viruses can also lead to hepatic inflammation.Hepatitis A VirusHepatitis A virus (HAV) is transmitted through the fecal–oral route, typically by ingestion of food...


