CAJ | 학술논문

目的探讨滤纸片干血斑技术在婴儿HIV早期诊断中的应用效果.方法于2010-2011年在云南省昆明、大理、德宏和临沧市(州)的14个妇幼保健院中,对所有感染HIV的孕妇所生的6周至18个月的婴儿进行调查,共计286名.采用滤纸片干血斑采血与罗氏HIV-1 DNA检测技术对HIV感染产妇所生的婴儿进行HIV早期诊断研究,并与18个月时婴儿的HIV抗体结果进行比较.同时阶段性采集并检测滤纸片干血斑的HIV抗体,了解未感染HIV婴儿的抗体阴转时间.并对孕妇抗病毒治疗情况及婴儿母乳喂养情况进行调查.结果在286名婴儿中,有148名男性、138名女性.对286名婴儿进行了HIV-1 DNA检测,有8名婴儿HIV-1 DNA检测结果为阳性,HIV感染率为2.8％(8/286),与18个月时婴儿的HIV抗体检测结果完全一致；其余278名DNA检测结果为阴性的婴儿,其抗体也均为阴性.对143名HIV-1 DNA阴性的婴儿进行随访,其在出生后6、9、12和18个月时的累计抗体阴转率分别是14.0％(20/143)、61.5％(88/143)、88.1％ (126/143)和100.0％( 143/143).286例感染HIV的孕妇中,抗病毒治疗组孕妇所生婴儿的HIV感染率为2.14％(6/280),未抗病毒治疗孕妇组婴儿HIV感染率为33.33％ (2/6),差异有统计学意义(P＜0.01).人工喂养组婴儿的HIV感染率为2.55％ (7/274),纯母乳喂养组婴儿HIV感染率为8.33％(1/12).结论滤纸片干血斑HIV-1 DNA检测方法可以较好地应用于6周至18个月龄婴儿HIV感染的早期诊断.
목적 탐토려지편간혈반기술재영인HIV조기진단중적응용효과.방법 우2010-2011년재운남성곤명、대리、덕굉화림창시(주)적14개부유보건원중,대소유감염HIV적잉부소생적6주지18개월적영인진행조사,공계286명.채용려지편간혈반채혈여라씨HIV-1 DNA검측기술대HIV감염산부소생적영인진행HIV조기진단연구,병여18개월시영인적HIV항체결과진행비교.동시계단성채집병검측려지편간혈반적HIV항체,료해미감염HIV영인적항체음전시간.병대잉부항병독치료정황급영인모유위양정황진행조사.결과 재286명영인중,유148명남성、138명녀성.대286명영인진행료HIV-1 DNA검측,유8명영인HIV-1 DNA검측결과위양성,HIV감염솔위2.8％(8/286),여18개월시영인적HIV항체검측결과완전일치；기여278명DNA검측결과위음성적영인,기항체야균위음성.대143명HIV-1 DNA음성적영인진행수방,기재출생후6、9、12화18개월시적루계항체음전솔분별시14.0％(20/143)、61.5％(88/143)、88.1％ (126/143)화100.0％( 143/143).286례감염HIV적잉부중,항병독치료조잉부소생영인적HIV감염솔위2.14％(6/280),미항병독치료잉부조영인HIV감염솔위33.33％ (2/6),차이유통계학의의(P＜0.01).인공위양조영인적HIV감염솔위2.55％ (7/274),순모유위양조영인HIV감염솔위8.33％(1/12).결론 려지편간혈반HIV-1 DNA검측방법가이교호지응용우6주지18개월령영인HIV감염적조기진단.
Objective To explore the application od Dried Blood Spot (DBS) testing for early detection of HIV infection among infants.Methods All of the infants aged between 6 weeks and 18 months and born by HIV positive mothers from 14 Maternity and Child Health Care Hospitals in Kunming,Dali,Dehong,Lincang of Yunnan province were investigated from 2010 to 2011.By using DBS and Roche HIV-1 DNA test techniques,286 infants were tested for HIV early diagnosis and compared with HIV antibody results of 18 months infants.DBS from uninfected infants were taken periodically and screened of HIV antibody to find their time of antibody-disappearing.The information of treatment for pregnant women and feeding methods for infants was also investigated.Results A total of 286 infants were tested with HIV-1 DNA among which 148 infants were male and 138 infants female,and 8 infants were HIV-1 DNA positive and the infection rate was 2.8％ (8/286) that was in accord with their antibodies results in 18 months old; the other 278 infants whose HIV-1 DNA was negative was also negative with their antibodies.By following up the antibody test of 143 HIV negative infants the cumulate rates of antibody-disappearing at the age of 6,9,12 and 18 months were 14.0％ ( 20/143 ),61.5％ ( 88/143 ),88.1％ ( 126/143 ) and 100.0％ ( 143/143 ),respectively.Among 286 HIV positive pregnant women,the group with anti-viral treatment had a lower rate of HIV infection with their infants that was 2.14％ (6/280)while the group without anti-viral treatment had a high rate of HIV infection with their infants that was 33.33％ (2/6).There was significandy different in the rates of two groups ( P ＜ 0.01 ).The HIV infection rate of infants fed with milk powder was 2.55％ ( 7/274 ) and the rate was 8.33％ (1/12) with breast milk.Conclusion The HIV-1 DNA detection techniques with DBS sample was effective for the early diagnosis of HIV in infants from 6 weeks to 18 months.