艾滋病毒病毒控制器中的怀孕管理:二十年的经验
Charlotte-Eve S Short1,2,3, Laura Byrne4,5, Aishah Hagan-Bezgin1,6
1Department of Infectious Disease, Imperial College London, London W2 1PG, UK.
Pathogens (Basel, Switzerland)
|April 26, 2024
概括
孕妇自发HIV病毒控制的管理已经发展. 2012年后,英国的实践从齐多夫丁单疗转向了三重ART,尽管在一些怀孕中检测到病毒,但没有报告HIV传播.
科学领域:
- 产科和妇科 产科和妇科
- 传染性疾病 传染性疾病
- 病毒学 病毒学
背景情况:
- 有限的证据表明,怀孕的孕妇可以自发控制艾滋病病毒.
- 这项研究研究了英国妇女的结局,艾滋病毒病毒载量<100副本/毫升的抗逆转录病毒疗法 (ART).
研究的目的:
- 描述自发HIV病毒控制妇女怀孕的管理和结果.
- 为了比较2012年之前和之后的结果,当时英国的指导方针改变了第一线ART选择.
主要方法:
- 一个多中心的回顾性病例系列 (1999-2021) 分析了匿名的人口,病毒学,产科和新生儿数据.
- 在2012年之前 (通常使用齐多夫丁单疗法) 和2012年后 (使用不同的ART疗法) 管理的怀孕之间的比较.
主要成果:
- 在29名妇女中发生了49例活产;在2012年之前的35例和2012年后的14例.
- 在2012年之前的管理主要涉及齐多武丁单疗法 (ZDVm) 和产前剖腹产 (PLCS).
- 2012年后,三重ART更常见 (10/14),ZDVm更少 (4/14),具有多种交付方式,并且没有产后ZDV输注. 在29%的怀孕中检测到HIV (>50副本/毫升);没有发生传播.
结论:
- 在怀孕期间使用自发HIV病毒控制剂的英国临床实践在指导方针变化后得到了调整.
- 尽管在ART和分娩管理方面发生了变化,但剖腹产率基本保持不变.
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