携带艾滋病毒也能生健康宝宝 染病毒几率1%

携带艾滋病毒也能生健康宝宝染病毒几率1%

http://www.gxnews.com.cn 2009年10月30日 08:56 来源：广西新闻网-当代生活报
广西新闻网记者韦夏实习生覃琴文/图

　　“是阴性！是阴性！”10月27日，同为艾滋病毒携带者的一对夫妻，在南宁市一家传染病医院拿到了他们18个月大的儿子的艾滋病抗体检测报告单。

　　报告单显示，孩子并未感染艾滋病毒。

　　这也是该院采用三联抗病毒治疗措施，成功阻断艾滋病母婴传染的众多案例之一。

　　【震惊】

　　怀孕3个月，查出母亲感染艾滋病毒

　　“我怎么这么不幸，感染上这种病啊？！”2007年9月底，来自郊区农村、已怀孕3个月的王细妹看着手中那张艾滋病抗体检测化验单，怔怔地站在某传染病医院空旷的院子里，身子摇摇欲坠。

　　接着，她发疯似的跑进妇产科医生办公室，抓住该科室庞医师的臂膀，哭着问道：“我的宝宝怎么办？我的宝宝怎么办？”

　　王细妹是在该院做产前检查的时候，被检测出HIV呈阳性的，这意味着她是一位艾滋病毒携带孕妇。
【原因】

　　婚前有过多个性伴侣，艾滋病毒沾上身

　　在诊室里，庞医师耐心地劝导王细妹，并详细询问了她的生活习惯和病史。

　　王细妹，25岁，初中毕业后曾到广东打工，其间先后结交过两个男朋友，并分别与之同居过一段时间。据其回忆：“当时我只知道第二个男朋友吸过毒，但从来没有过问他以前的情况。同居一段时间后，我们就分手了。”

　　“从患者回忆中，我们很容易找出她什么时候有过高危行为。艾滋病传播途径主要有以下3点：血液、性和母婴传播，其中性行为是艾滋病毒传播的一个重要途径。王细妹第二个同居男友很有可能就是艾滋病毒携带者，她是在与其同居期间被感染的。”庞医师告诉记者。

　　随后，庞医师建议王细妹叫丈夫也赶来医院做相关检查。果然不出医生所料，王细妹丈夫的HIV检测结果也呈阳性。据了解，其丈夫婚前也曾有过多个性伴侣，因此，很难简单地判定两人间究竟是谁将艾滋病毒传染给了谁。

　　“艾滋病毒携带者在被感染初期，基本没有什么症状。大部分艾滋病毒的潜伏期在5-10年之间，比较隐蔽。因此，许多孕产妇都是怀孕后或临产前才知道自己感染了艾滋病毒的。”
【决定】

　　采取干预措施，将宝宝生下来

　　冷静下来之后，王细妹开始向医生咨询，自己肚子里3个月大的宝宝，该留还是不留？

　　“如果从现在开始采取三联抗病毒治疗措施，生产时再小心操作注意安全；孩子生下来后采用人工喂养，把这3方面工作都做好的话，宝宝生下来后感染艾滋病毒的几率只有1%，有希望生下一个健康宝宝。”

　　“但是，风险也是有的。比如宝宝很可能在生产过程中受到病毒感染，那样的话，就算生下来能够存活下去，也是一个‘药坛子’，而且很难活过5年。如果父母先于孩子发病离世，谁来照顾孩子也是一个大问题。”

　　“我丈夫家就他一根独苗，全家人都把希望寄托在这孩子身上了。放弃宝宝，谁都舍不得呀！” 认真听完医生意见，并分析了生孩子的利弊后，王细妹与丈夫没有相互猜疑，而是下定了要生下宝宝的决心。

　　【成功】

　　1岁半儿子HIV呈阴性

　　“夫妻同时感染艾滋病毒，只要艾滋病没有发作，进行母婴阻断的成功率相当高。我们可以做到，让99%的艾滋病毒携带夫妻生下健康宝宝。”

　　庞医师介绍，经过测试，他们发现王细妹可以做到自始至终严格遵循医嘱服药和定期体检，与医生配合也相当默契，于是决定免费为其施行艾滋病母婴阻断治疗，并对其整个阻断过程进行严密监测。

　　“抗病毒药物一定要按时服用，因为治疗艾滋病不像治疗感冒发烧，感觉好点就可以不再吃药。由于孕期服药对胎儿有一定影响，因此我们在开方配药时都特别小心，孕早期尽量避开那些可致胎儿畸形的药物，同时又要保证药物可以控制病毒复制发展，降低病毒载量，减少耐药毒株的产生。”

　　“我们临床发现，单是孕期采取规范的抗病毒治疗一项，就可将母婴传播率降低60%-70%。”

　　去年4月，王细妹剖腹产下一名男婴。此后，庞医师又对他们母子的治疗方案进行了调整。但新生儿是否感染艾滋病毒当时无法判断，一般要等到18个月之后，通过病毒载量检测，才能得知最终结果。

　　经过一年半的持续跟踪服务，终于有了本文开头的一幕。

　　获知儿子的艾滋病毒抗体检测结果为阴性，母婴阻断成功之后，王细妹喜极而泣。她紧紧握着医护人员的手，久久不愿松开，感激的话语也不知该从何说起。

　　庞医师高兴地说，看着王细妹的儿子蹦蹦跳跳、开心玩耍的样子，她感觉特别开心。

　　“今后，我们还要把艾滋病母婴阻断成功的方法在全区各级医院培训、推广，让更多的艾滋病毒携带夫妻生下健康宝宝！”

    HIV can also be HIV infected health risk of a healthy baby 1% http://www.gxnews.com.cn 2009 Nian 10 Yue 30 Ri 08:56 Source: Guangxi News Net - Contemporary Al-Hayat
Guangxi News reporter trainee Qin Qin Vescia text / Map

"Is negative! Is negative!" 10 27, with people living with HIV for a pair of couples, an infectious disease hospital in Nanning city to get their 18-month-old son of the HIV antibody test report card.

Report card shows that the child was not infected with HIV.



This is also the hospital with triple antiretroviral therapy and successfully blocked mother to child transmission of HIV is one of many cases.

【Shocked】

3 months of pregnancy, to identify HIV-infected mothers

"How do I so unfortunately, infected with the disease ah?!" By the end of September 2007 from suburban and rural areas have been pregnant 3 months looking at the hands of Wang Xi-Mei goes on HIV antibody testing laboratory orders, Zheng Zheng stood an infectious disease Hospital empty courtyard crumbling body.

Then she frantically ran into the maternity doctor's office, seizing the doctor's arm sections Pang, crying, asked: "My baby how to do? My baby how to do?"

Wang Xi-Mei is doing prenatal care in the hospital when being detected HIV positive, which means that she is carrying a pregnant woman with HIV.
     【Reason】

There are too many pre-marital sexual partners, HIV stained body



In the consulting room, the doctor patiently to persuade Pang Wang Xi-mei, and inquired in detail about her lifestyle and medical history.

Wang Xi-Mei, 25-year-old junior high school after graduation went to work in Guangdong, during which has had two boyfriends make, and were living together with them for a time. According to its recalled: "At that time I only know that the second boyfriend, smoked drugs, but never say in his previous situation. Cohabitation period of time, we broke up."

"From the patient's memories, we can easily find out when she had high-risk behavior. AIDS main mode of transmission has the following 3 points: blood, sex and mother to child transmission, in which sex is the spread of HIV in an important way. Wang Xi-mei article 2 cohabitant was most likely living with HIV, she was infected during their cohabitation. "Pang told reporters physician.

Subsequently, Wang Xi-Mei Pang told the doctor suggested that her husband rushed to the hospital is also related to inspections. Sure enough, not doctors expected, WANG Xi-mei, her husband's HIV test results are positive. It is understood that her husband also have too many sex partners before marriage, it is difficult to simply determine whether it is between two people who will be living with HIV transmitted to whom.

"HIV carriers were infected in the early days with hardly any symptoms. Most of the HIV virus, the incubation period between 5-10 years, compared hidden. Thus, many pregnant women are pregnant or give birth before the commencement of their HIV infection poisoning. "
     【Decided】

Interventions will be born baby



Calm down, Wang Xi-mei started to doctor, his stomach three month-old baby, the stay or not stay?

"If from now on triple antiretroviral therapy started to take measures, production operations carefully and pay attention to safety; child was born after the use of artificial feeding, these three aspects of work doing what they do, then after the baby was born infected with HIV is only one chance %, there is hope gave birth to a healthy baby. "

"However, the risk is there. Such as baby in the production process is likely to be infected, so the case, even if born to be able to survive, but also a 'drug jars', and difficult to survive for 5 years. If the parents before their children incidence of death, who will take care of their children is also a big problem. "

"My husband is an only child on his family, the family people put their hopes in these children bodies. Abandoned baby, and no one reluctant呀!" Seriously listening to medical advice, and analyzes the pros and cons of a child, Wang Xi-mei and her husband did not mutual suspicion, but rather make up its mind to give birth to babies in determination.

【Successful】

1-year-old son, HIV-negative semi -

"Husband and wife are also infected with HIV, as long as there is no onset of AIDS, to conduct PMTCT success rate very high. We can do, so that 99% of the HIV virus carrying the couple gave birth to a healthy baby."

Dr. Pang introduced, tested, they found that Wang Xi-Mei can be done from start to finish strictly follow the doctor's orders medication and regular medical examinations, with quite a tacit agreement with the doctor and decided to free treatment for the purposes of AIDS, PMTCT, and its entire block process closely monitored.

"Antiviral drugs must be taken on time, because unlike the treatment of AIDS treatment with a fever, feel better you can not take medicine. As the medication during pregnancy has a certain impact on the fetus, so we are particularly careful when prescribing dispensing, early pregnancy try to stay away from drugs can cause fetal malformation, at the same time ensure that the development of drugs to control viral replication and reduce viral load to reduce the production of drug-resistant strains. "

"We have clinical findings alone during pregnancy to a standard anti-virus treatment, the rate of mother to child transmission can be reduced by 60% -70%."

Last year, in April, Wang Xi-mei Caesarean section to a baby boy. Since then, the Pang doctor again for their son's treatment programs have been adjusted. But the newborn is infected with HIV were not able to judge, generally have to wait until 18 months later, through viral load testing, before we get the final result.

After a year and a half of continuous follow-up service has finally found a scene at the beginning of this article.

Informed of his son's HIV test results were negative, after the success of PMTCT, Wang Xi-Mei cried. She firmly shook the hands of medical staff were reluctant to release, words of gratitude do not know where to start with.

Dr. Pang said happily, looking at the son of Wang Xi-mei, skipping, happy playing like that she feels especially happy.

"In the future, we need to put AIDS PMTCT approach has been successful at all levels of hospital training in the region, promoting, so that more of the HIV virus carrying the couple gave birth to a healthy baby!"