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目的探讨女方HIV阴性,而男方HIV阳性者夫妇或性伴侣经暴露前预防后行无保护性性交并妊娠的结果进行分析。方法筛选15例符合入组标准并有妊娠生育期待的夫妇或性伴侣进行妊娠前咨询,女方需要知道HIV感染的危险可能降低,但不能排除。女方在首次授精前3个月左右开始自行记录基础体温,确定大致排卵时间。男方为HIV阳性患者,且CD_4~+ T淋巴细胞>250个/μl,病毒载量<50拷贝/ml。女性性伴侣在每个排卵周期授精2次,在无保护性性交前24h服用齐多夫定(300 mg,2次/d),拉米夫定(300mg,1次/d),克力芝(500 mg,2次/d),第2次授精后24h停止预防。如未妊娠重复上述周期。首次无保护性性交后1、3、6、12、18个月检测女方HIV抗体。结果采用暴露前预防后无保护性性交15例夫妇或性伴侣妊娠生育7例,妊娠率47%(7/15)。15例入选病例研究终点均未发现女性HIV感染。结论采用暴露前预防的方法可以降低未感染女性的易感性,为男性HIV感染者的生育期待提供了一种帮助。
Objective To investigate the HIV-negative status of the woman, and to analyze the results of unprotected sexual intercourse and pregnancy after the prevention of HIV-positive couples or sexual partners. Methods Screening of 15 pre-pregnancy counseling couples or sexual partners who meet the inclusion criteria and expecting to have a pregnancy expectation, the woman needs to know that the risk of HIV infection may be reduced but not excluded. The first 3 months before fertilization, the woman began to record their own basic body temperature to determine the approximate ovulation time. The man is HIV-positive and contains> 250 cells / μl of CD_4 ~ + T lymphocytes with a viral load of <50 copies / ml. Female sexual partners fertilize twice a week for ovulation, take zidovudine (300 mg twice daily), lamivudine (300 mg once daily) for 24h before unprotected sexual intercourse, (500 mg, 2 times / d), stop the prevention 24 h after the second insemination. If not repeat the cycle of pregnancy. Female HIV antibody was detected at 1, 3, 6, 12 and 18 months after the first unprotected sexual intercourse. Results Pre-exposure prophylaxis without protection of sexual intercourse in 15 cases of couples or sexual partners in 7 cases of pregnancy, pregnancy rate was 47% (7/15). No female HIV infection was found at the end of the 15 case-studies. Conclusion Pre-exposure prophylaxis can reduce the susceptibility of uninfected women and provide a help for the fertility expectation of male HIV-infected persons.