title: [Efficacy analysis of different antiretroviral drug regimens in mother to child HIV transmission prevention in some regions of China].
abstract: OBJECTIVE
  To determine the efficacy of different antiretroviral drug regimens in mother to child HIV transmission prevention (PMTCT) in China.
  
  
  METHODS
  From January 1st 2006 to Dec 30th 2008, a total of 1072 pairs of HIV positive pregnant women and their babies who were HIV antibody positive and older than 18 months were recruited in this study. These women who had received maternal health care in health care institutions were from 23 provinces. Subjects were investigated by questionnaire, including social demographic data, usage of ARVs, safe delivery and artificial feeding, and other PMTCT related informations. The trend of different antiretroviral drug regiments in different period were analyzed by Cochran-Mantel-Haenszel (CMH) χ(2) test. By stratified analysis and Fisher exact χ(2) test, the efficacy of different antiretroviral drug regimens in mother to child HIV transmission prevention were studied. Antiretroviral drug regimens applications mainly included sd-NVP drug regimen, prophylaxis regimen and highly active anti-retroviral therapy (HAART).
  
  
  RESULTS
  Among 1072 pairs of HIV positive maternities and babies, 31 babies older than 18 months were HIV infected, MTCT rate was 2.9% (31/1072). (1) The proportion of using ARVs was increasing from 76.4% (306/395) in 2006 to 83.8% (372/444) in 2008, the difference was significant (CMH χ(2) = 6.4, P < 0.05). (2) The ratio that HIV infected maternities adopted ARVs rose from 3.4% (6/178) in 2006 to 26.3% (104/395) in 2008, the ratio increased year by year (CMH χ(2) = 53.1, P < 0.01). On the contrary, usage of sd-NVP declined from 88.8% (158/178) in 2006 to 70.9% (264/372) in 2008 (CMH χ(2) = 48.5, P < 0.01). (3) Among maternities adopted vaginal delivery and artificial feeding, the MTCT rate of ARVs combination group was 1.0% (1/104), while the MTCT rate of sd-NVP group was 5.9% (16/272) (Fisher χ(2) = 5.5, P < 0.05). (4) In the case of artificial feeding, the MTCT rate of prophylaxis regimens and HAART among maternities adopted vaginal delivery was 3.1% (1/32) and 0 respectively. Among maternities adopted cesarean delivery, MTCT rate of prophylaxis regimens and HAART was 3.2% (2/63) and 3.1%(1/32) respectively, both showed no significant difference (Fisher χ(2) = 1.4, P > 0.05; Fisher χ(2) = 0.0001, P > 0.05).
  
  
  CONCLUSIONS
  Effect of combination of antiretroviral drugs to PMTCT is obvious, the rate of mother to child HIV transmission of prophylaxis regimens and HAART has not shown significant difference.
authors.affiliation: National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Lin-hong
authors.initials: LH
authors.lastname: Wang
authors.forename: Li-wen
authors.initials: LW
authors.lastname: Fang
authors.forename: Qian
authors.initials: Q
authors.lastname: Wang
authors.forename: Xiao-yan
authors.initials: XY
authors.lastname: Wang
authors.forename: Fang
authors.initials: F
authors.lastname: Wang
authors.forename: Ai-ling
authors.initials: AL
authors.lastname: Wang
authors.forename: Ya-ping
authors.initials: YP
authors.lastname: Qiao
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000517:prevention & control / Q000635:transmission; D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D000998:Antiviral Agents / Q000008:administration & dosage; D002681:China; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D055815:Young Adult
chemical_list: D000998:Antiviral Agents