사람면역결핍바이러스 수직감염 예방치료 3례
Three Cases of Prevention Therapy to Reduce Perinatal HIV Transmission
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
The Joint United Nations Programme on HIV/ AIDS (UNAIDS)의 통계에 의하면 2008년 한 해에 43만 명의 어린이가 HIV 에 감염된 것으로 보이며 대부분 수직감염에 의한 것으로 나타났다. 수직감염의 예방 프로그램은 이러한 감염을 줄일 수 있는 가장 효과적인 방법이다. 2009년 국립중앙의료원에는 HIV에 감염된 산모로부터 출생한 신생아 3명이 입원하였다. 이들의 산모 2명은 ARV 치료제를 투여하였고 1명은 투여하지 못했으며 3명의 환아에게는 모두 ARV 치료를 하였다. 추적관찰을 4개월에서 16개월 동안 실시한 결과 아직까지는 HIV 수직감염이 의심될 수 있는 혈청학적 검사의 특이소견은 보이지 않고 있다. 임산부에 대한 HIV 산전검사의 확대, 조기진단 및 효과적인 ARV 치료만이 수직감염을 낮출 수 있을 것이며 저자는 이에 대한 수직감염 예방치료 3례를 경험하였기에 보고하는 바이다.
Abstract
In 2008, the Joint United Nations Programme on HIV/AIDS (UNAIDS) estimated that about 430,000 children worldwide became infected with HIV, mostly through mother-to-child transmission (MTCT) during pregnancy, labor, delivery, or breast- feeding. The MTCT prevention program proved to be feasible and effective in reduction of perinatal HIV transmission. Three babies born from HIV-infected mothers were admitted to the National Medical Center in 2009. Only two women received antiretroviral (ARV) therapy during pregnancy, labor, and after delivery, and their infants received zidovudine (AZT) for 6 weeks. The outcome, after a follow-up period of 4 months to 16 months, was favorable in all patients. Thus, we emphasize the need for expansion of antenatal HIV screening of pregnant women, implemented for early HIV diagnosis and effective ARV therapy for reduction of perinatal HIV transmission.
참고문헌 (19)
- Adeleke SI, "Awareness and knowledge of mother-to-child transmission of HIV among mothers attending the pediatric HIV clinic, Kano, Nigeria", Ann Afr Med, 8, pp.210~214 (2009)
- Kourtis AP, "Understanding the timing of HIV transmission from mother to infant", JAMA, 285, pp.709~712 (2001)
- Dao H, "International recommendations on antiretroviral drugs for treatment of HIV-infected women and prevention of mother-to-child HIV transmission in resource-limited settings: 2006 update", Am J Obstet Gynecol, 197, pp.42~55 (2007)
- Jamieson DJ, "Recommendations for human immunodeficiency virus screening, prophylaxis, and treatment for pregnant women in the United States", Am J Obstet Gynecol, 197, pp.26~32 (2007)
- Paintsil E, "Update on successes and challenges regarding mother-to-child transmission of HIV", Curr Opin Pediatr, 21, pp.94~101 (2009)
- "Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1- Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States"[URL]
- Connor EM, "Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. Pediatric AIDS Clinical Trials Group Protocol 076 Study Group", N Engl J Med, 331, pp.1173~1180 (1994)
- Zhou Z, "Prevention of mother-to-child transmission of HIV-1 using highly active antiretroviral therapy in rural Yunnan, China", J Acquir Immune Defic Syndr, 53, pp.15~22 (2010)
- Newell ML, "Antenatal and perinatal strategies to prevent mother-to-child transmission of HIV infection", Trans R Soc Trop Med Hyg, 97, pp.22~24 (2003)
- Coovadia H, "Current issues in prevention of mother-to- child transmission of HIV-1", Curr Opin HIV AIDS, 4, pp.319~324 (2009)
- Mofenson LM, "Risk factors for perinatal transmission of human immunodeficiency virus type 1 in women treated with zidovudine", N Engl J Med, 341, pp.385~393 (1999)
- John GC, "Correlates of mother- to-child human immunodeficiency virus type 1 (HIV-1) transmission: association with maternal plasma HIV-1 RNA load, genital HIV-1 DNA shedding, and breast infections", J Infect Dis, 183, pp.206~212 (2001)
- O'Gorman MR, "CD4 T cell measurements in the management of antiretroviral therapy--A review with an emphasis on pediatric HIV-infected patients", Cytometry B Clin Cytom, 74, pp.19~26 (2008)
- Giaquinto C, "HIV: mother to child transmission, current knowledge and on-going studies", Int J Gynaecol Obstet, 63, pp.161~165 (1998)
- Shaffer N, "Short-course zidovudine for perinatal HIV-1 transmission in Bangkok, Thailand: a randomised controlled trial. Bangkok Collaborative Perinatal HIV Transmission Study Group", Lancet, 353, pp.773~780 (1999)
- Dunn DT, "Interventions to prevent vertical transmission of HIV-1: effect on viral detection rate in early infant samples", AIDS, 14, pp.1421~1428 (2000)
- Pinkerton SD, "Incremental cost-effectiveness of two zidovudine regimens to prevent perinatal HIV transmission in the United States", Prev Med, 30, pp.64~69 (2000)
- Pyrgos V, "Pneumocystis pneumonia in children", Paediatr Respir Rev, 10, pp.192~198 (2009)
- King SM, "American Academy of Pediatrics Committee on Pediatric AIDS; American Academy of Pediatrics Infectious Diseases and Immunization Committee. Evaluation and treatment of the human immunodeficiency virus-1--exposed infant", Pediatrics, 114, pp.497~505 (2004)