発症率が高い地域での産後HIV感染の撲滅: 補完的な生物医学介入の必要性

Philippe Van de Perre¹, Ameena Goga², Nobubelo Ngandu³

¹Pathogenesis and Control of Chronic and Emerging Infections, INSERM, University of Montpellier, Etablissement Français du Sang, Antilles University, CHU Montpellier, Montpellier, France.

Lancet (London, England)

|April 4, 2021

まとめ

母から子へのHIV感染は増加しています現在の方法は不十分であるため,この感染経路を排除するために新しい生物医学戦略が緊急に必要です.

科学分野:

感染症
公衆衛生
免疫学

背景:

母から子へのHIV感染 (MTCT) は,依然として世界的な健康問題です.
抗レトロウイルス療法 (ART) によって子宮内および子宮内MTCTの割合は低下していますが,母乳育児によるMTCTは比例して増加しています.
治療を受けていない母親のHIVと産後HIV感染は,産後MTCTのリスクを高めます.

研究の目的:

他の感染経路と比較して母乳育児によるHIVMTCTの増加率を強調する.
哺乳に関連するMTCTを排除するための現在の戦略の潜在的不十分性を強調する.
新しい生物医学的な介入の緊急評価と実施を提唱する.

主な方法:

HIVのMTCTの現在の傾向のレビュー
授乳によるMTCT増加に寄与する要因の分析
生物医学における新たな予防戦略の特定

主要な成果:

他の感染経路と比較して授乳によるMTCTの割合は増加しています
現行の戦略は,普遍的に適用されない場合,母乳育児を通じてMTCTを排除することはできません.
授乳による産後HIV感染の予防にはギャップがあります.

結論:

母乳育児からMTCTを排除するには,追加の生物医学戦略を緊急に実施する必要があります.
予防策には,リスクのある授乳中の女性の暴露前予防,産後強化 (再検査,ケア,乳児予防),免疫予防 (ワクチンまたは抗体) が含まれます.
標的を絞った介入は,高いHIV感染率と発生状況において極めて重要です.

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