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About PMTCT for about 8,000 HIV-infected Pregnant Women Annually in China

Posted on 2019-12-01 View 3 times

AIDS is not far away from our life, but instead, a serious infection of severe harmfulness, resulting in a high fatality rate, being incurable currently and having no vaccine for prevention.

December 1 in 2019 is the 32nd World AIDS Day.

The promotional campaign in China this year is Communities Make the Difference. A thematic focus has been set on the advantages and role on AIDS preventing and treating by such communities as social organizations, medical and health institutions at grass-roots level, residential committees and village committees. It has also been dedicated to raising awareness of being responsible for individual fitness, by joint efforts with governments, divisions, and other social institutions in terms of prevention and control of the given disease and of promotion corresponding to the stated theme, with contributions to curbs on the AIDS pandemic and the construction of a healthy country.

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The Theme of the World AIDS Day 2019

Communities make the difference

National Health Commission of the People’s Republic of China   

The office of the AIDS Prevention Committee of the State Council

The Public

I. About the Understanding of harmfulness

AIDS is not far away from our life, but instead, a serious infection of severe harmfulness, resulting in a high fatality rate, being incurable currently and having no vaccine for prevention.

Being not unusual in the common life, there were 149,000 new HIV/AIDS cases in China, according to the report in 2018, more than 90% of which were attributed to sexual transmission. 17 new such cases have been mounted per hour on average.

Infection of AIDS will cause a huge impact on life, since regular taking of drugs will be triggered loaded with increasingly mental pressure.The immune system of man will be subject to progressive destruction by viruses; absence of medicine taking regularly will be followed by rapid worsening when the disease attacks.

Common symptoms include infection of the skin and mucous membrane; appearance of herpes simplex, herpes zoster, blood blister, or congestion spots and amid others; and persistent fever; pneumonia, tuberculosis, cough, dyspnea, persistent diarrhea, hematochezia, hepatosplenomegaly, and complicated by malignant tumor

So far worldwide, no method has been available to cure AIDS, nor any vaccine to prevent.

II. About Knowledge of Prevention

HIV can spread through sexual contact, blood, or from mother to child transmission.

Innumerous HIV viruses are carried in such bodily fluids of a person with HIV as blood, semen, vaginal secretions, milk, wound exudates, and are with a strong infection.

Sexual contact has been the chief contributor to ADIS, viruses of which can be spread amongst both genders or amid males during their sexual intercourse (vaginal, oral, anal).

It is difficult to catch HIVs during contact in daily, since the viruses become weakened to the external environment after departure from a human body. Such public facilities will offer no transmission as toilets, telephones, catering devices, bedding equipment, swimming pools or baths, nor will coughs, sneezes, or bites by mosquitoes or other insects spread.

In China, about 30% HIV cases are females, with an estimated sum of about 8,000 HIV-infected pregnant women added annually. Most new baby cases are transmitted from mother to child. The infected incidence will get a rise of 15-25% during pregnancy and delivery and of 5-20% during breast-feeding, where no measure is taken to prevent the mother-to-child transmission.

The Mother-and-baby World

I. Ways of mother to child transmission of AIDS, syphilis and hepatitis B

Intrauterine Transmission: viruses can be transferred to the baby via the placenta during pregnancy

Delivery Transmission: infection can be caught by contact of by contact with the mother’s blood, amniotic fluid and secretions in the course.

Breast-feeding Transmission: infection can be caused by breast-feeding.

II. Harmfulness on kids by AIDS, syphilis and hepatitis B

The incidence of mother-to-kid transmission is roughly 1/3, where no measure is taken to prevent the AIDS. The stated way has become the leading factor for kids under the age of 15 to catch the disease; a majority of their life will come to an end before 5 if no treatment is involved.

Syphilis can be transferred to the baby via the placenta, notably resulting in spontaneous miscarriage, stillbirth, dead-birth or congenital syphilis. Even such a baby survives, it can catch hepatosplenomegaly, periosteum inflammation, nephrotic syndrome, and amid others, where no measure is engaged for prevention.

Infants infected with hepatitis B can be carried with a chronic hepatitis B virus, and finally develop the chronic hepatitis B.

III. Prevention of AIDS, syphilis and hepatitis B via the mother-to-child transmission

Examination of eugenics before marriage and pregnancy: such examination for couples shall be involved, particularly that of AIDS, syphilis and hepatitis B. In case of any infection, immediate treatment shall be adopted.

Examination in pregnancy: women in early pregnancy are expected to accept consultation and checks concerning AIDS, syphilis and hepatitis B. In case of any infection of AIDS, the couple involved shall, on the basis of pro consultation and family discussion, make their own choice on whether to end the pregnancy. If the pregnancy is continued, targeted services shall be adopted for prevention of the mother-to-child transmission in the hospital involved, in company of medicine taking under the pro advice. If any infection of syphilis is found, immediate treatment shall be involved in the hospital institutions concerned, with a regular and standard course of treatment in the early and late pregnancy separately. For the maternal with HBsAg positive, the history and treatment of hepatitis in detail shall be available to the medical staff involved, coupled with close monitoring of the liver function and HBV DNAs, for the purpose of nutrition support and guidance and a transfer to a specialist if necessary.

Delivery prevention refers to effective measures employed to prevent babies from being infected during the delivery in hospital. The newly born babies with AIDS-infected mothers shall take antiviral drugs; it all depends whether to take preventives for the newborns to the maternal with syphilis, and standard treatment against syphilis shall be conducted when congenital syphilis is diagnosed. For a newborn to a mother with HBsAg positive, injection of hepatitis B immunoglobulin (100 units) shall be conducted within 24 hours after birth; hepatitis B vaccination for 3 times in total shall be accompanied to babies within 24 hours after birth, and one and six months old respectively, according to requirements of the national immunization program.

Follow-up visits to kids: diagnoses and examinations shall be conducted for a newborn to a mother with AIDS and of 6 weeks and 3 months old respectively, to see if there is any infection. In case that no early diagnosis test of AIDS infection has been carried out or the early diagnosis test results are negative, antibody tests shall be conducted to a newborn of 12 and 18 months old respectively, to check whether the baby has caught the AIDS. For the newborn within a couple of months and to the maternal with syphilis, a nontreponemal quantitative test should be carried out, to see whether they are infected with syphilis. For a baby of 7 and later 12 months old and to a mother with hepatitis B, two and a half pairs of tests can be adopted to decide the immune effect.

IV. About the subsidy policies by the State for preventions of mother-to-child transmission

Free examinations and consultation of AIDS, syphilis and hepatitis B for the maternal

A fund subsidy to services of preventing mother-to-child transmission for the maternal with AIDS as well as their newborns

Subsidies notably include free services of the diagnosis of HIV antibodies, examinations and tests of CD4+T lymphocyte, viral load tests, as well as relevant tests of anti HIV drugs; early diagnoses and tests for the newborns to the maternal with AIDS; antiviral drugs for mothers and babies and for prophylactic medications for opportunistic infections; subsides to the maternal with HIVs for pregnancy termination or hospital childbirths, and expenses for baby formula.

Subsidies to services of preventing mother-to-child transmission for the maternal with syphilis as well as their newborns have mainly included a nontreponemal quantitative test, standard treatment, and prevention and treatment of congenital syphilis to the said groups.

A subsidy to services of preventing mother-to-child transmission for the maternal with hepatitis B as well as their newborns has notably included free injection of hepatitis B immunoglobulin (100 units) for a baby to a mother with HBsAg positive.

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National Health Commission of the People’s Republic of China  

The office of the AIDS Prevention Committee of the State Council